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Research Letter |

Physicians’ Preferences for Hospice if They Were Terminally Ill and the Timing of Hospice Discussions With Their Patients

Garrett M. Chinn, MD, MS1; Pang-Hsiang Liu, MD, PhD2; Carrie N. Klabunde, PhD, MHS, MBA3; Katherine L. Kahn, MD4,5; Nancy L. Keating, MD, MPH2,6
[+] Author Affiliations
1Division of General Medicine, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston
2Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
3Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
4RAND, Santa Monica, California
5Division of General Internal Medicine, Department of Medicine, David Geffen School of Medicine, Los Angeles, California
6Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
JAMA Intern Med. 2014;174(3):466-468. doi:10.1001/jamainternmed.2013.12825.
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Physicians often delay hospice discussions with their terminally ill patients despite guidelines recommending such discussions for patients expected to die within 1 year,1,2 but reasons for this are not well understood. Evidence suggests that physicians “practice what they preach” when counseling about health behaviors,3 although their treatment recommendations may not necessarily reflect their own preferences, with one study suggesting they recommend more conservative treatments than they might choose for themselves.4 As physicians may prefer less aggressive end-of-life care than their patients generally receive,5 physicians’ personal preferences for hospice may influence their approach to hospice discussions with their terminally ill patients.

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Physician Willingness to Enroll in Hospice and Report of Early Hospice Discussions With Terminally Ill Patients With Cancer
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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