Physicians and the Hospice Decision: Awareness, Discussion, Reasons and Satisfaction

Abstract

ABSTRACTTwo complementary studies examined dimensions of physicians' involvement in the decision to enter hospice care. In Study 1, physicians practicing in three communities served by Medicare-certified hospices were surveyed by mail to determine their levels of awareness of hospice and the degree to which they discuss hospice with the terminally ill, and how these are affected by characteristics of their practice. Among the 45% who responded, over 90% were aware of hospice. In contrast, discussion of hospice was reported by only slightly over half. Nearly all comments about hospice (90%) were favorable. In Study 2, attending physicians of hospice patients were interviewed to determine their reasons for recommending hospice care, and their degrees of satisfaction with hospice. Aspects of support were identified as the most important reasons for recommending hospice; 97% of the physicians were satisfied with the decision that the patient enter hospice care. The gap between physicians' awareness of hospice and their discussing it is examined, along with its implications. Issues for future research are identified. Additional informationNotes on contributorsDavid S. GochmanDavid S. Gochman is with the Raymond A. Kent School of Social Work and Gordon S. Bonham is with the Urban Studies Center. They are both affiliated with the College of Urban and Public Affairs, University of Louisville. This research is part of a larger investigation generously underwritten through a grant from AARP/Andrus Foundation. It was conducted with the endorsement and cooperation of the Kentucky Association of Hospices, the Jefferson County, Fayette County and Boyd and Greenup County (Kentucky) Medical Societies, and was facilitated by the intense involvement of the Louisville, Lexington and Ashland hospices. The authors are most grateful for this support. They are also most appreciative of the competent research assistance of Linda Burgess, Ann Fream and Sherry Hutcherson. Portions of this paper were presented at the National Hospice Organization 1986 Annual Meeting and Symposium, Denver, November 19, 1986. Requests for reprints should be sent to David S. Gochman.