Doctors lack confidence to discuss end of life care

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Over half of doctors revealed they felt hesitant about discussing palliative care 

A new study has shown that 52% of healthcare providers do not feel confident enough to talk about end of life care with their heart failure patients.

The research, which surveyed 50 physicians and 45 nurse practitioners or physician assistants in America, also found that among the 52% who felt hesitant discussing end of life care, 11% of doctors felt uncomfortable bringing it up first, with 9% worried about destroying a sense of hope. 21% of medical professionals said they felt the patient wasn’t ready to discuss the issue of palliative care whilst 8% said they simply lacked time to talk about it.

Interestingly, 30% of the clinicians also said they felt unconfident about talking and providing end of life care, with only 12% of healthcare providers having routine yearly conversations about this issue.

American Heart Association statistics show that about 5.1 million Americans have heart failure and about half of those die within five years of their diagnosis.

End of life care

Among the 95 Mayo Clinic healthcare workers studied, there was also confusion over who should be bringing up the aspect of end of life care with the patient. 63% of heart failure specialists and 58% of community cardiology clinicians thought end of life care discussions were the responsibility of heart failure cardiologists, while 66% of primary care providers felt it was their responsibility.

Shannon Dunlay, M.D., M.S., the study’s lead researcher and a cardiologist at the Mayo Clinic in Rochester, Minnesota. said “Providers did express an interest in receiving additional training to develop the skills and confidence to talk about end-of-life care with their patients with heart failure.” Dunlay further emphasises that there is no evidence suggesting that talking about end of life care ruins hope for the patient, and in many cases it can ease anxiety for the patient and their family.

“Sometimes it’s helpful to pick up the phone and have a provider-to-provider conversation so that everybody is on the same page. Incorporating end-of-life conversations into the ongoing, routine care of the patient is important as goals and preferences can change over time and patients and their families can feel more comfortable and confident in relaying their wishes to multiple providers,” Dunlay recommends.

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