Open AccessPreferences of Physicians and Their Patients for End‐of‐Life Care
Author(s) -
Gramelspacher Gregory P.,
Zhou XiaoHua,
Hanna Mark P.,
Tierney William M.
Publication year - 1997
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1046/j.1525-1497.1997.00058.x
Subject(s) - medicine , family medicine , preference , primary care , odds ratio , odds , end of life care , medline , primary care physician , logistic regression , palliative care , nursing , political science , law , economics , microeconomics
OBJECTIVE: Both physicians and patients view advance directives as important, yet discussions occur infrequently. We assessed differences and correlations between physicians’ and their patients’ desires for end‐of‐life care for themselves. MEASUREMENTS AND MAIN RESULTS: Study physicians ( n = 78) were residents and faculty practicing in an inner‐city, academic primary care general internal medicine practice. Patients ( n = 831) received primary care from these physicians and were either at least 75 or between 50 and 74 years of age, with selected morbid conditions. Physicians and patients completed identical questionnaires that included an assessment of their preferences for six specific treatments if they were terminally ill. There were significant differences between physicians’ and patients’ preferences for all six treatments ( p < .0001), with physicians wanting less treatment than their patients for five of them. Patients desiring more care ( p < .01) were more often male (odds ratio [OR] 1.7), African‐American (OR 1.6), and older (OR 1.02 per year). There were no such correlates with physicians’ preferences. A treatment preference score was calculated from respondents’ desires to receive or refuse the six treatments. Physicians’ scores were highly correlated with those of their enrolled primary care patients ( r = .51, p < .0001). CONCLUSIONS: Although patients and physicians as groups differ substantially in their preferences for end‐of‐life care, there was significant correlation between individual academic physicians’ preferences and those of their primary care patients. Reasons for this correlation are unknown. KEY WORDS: end‐of‐life care; advance directives; patient preferences; physician preferences.