Study finds that dying patients and families suffer from lack of continuity of physician care

Mar 16 2009

In a study published in the March 9 issue of Archives of Internal Medicine, researchers found that patients and families can suffer from feelings of abandonment when a physician who had been actively involved in care is no longer involved.

Additionally, when there was no continuity between care providers, a lack of closure following the patient's death was found among families as well as the referring physicians and their staff.

National Hospice and Palliative Care Organization wants to emphasize the importance of the primary physician's ongoing involvement with a patient and family once a person has been referred and made the transition to hospice care.

"There are certainly challenges in maintaining ongoing communication between referring physicians and hospice providers, but this study demonstrates that there is a need," said J. Donald Schumacher, NHPCO president/CEO NHPCO. "Having a process in place that enables all parties to stay connected and informed is critically important in keeping the patient at the heart of care. In fact, regulations require it."

In the Centers for Medicare and Medicaid Services conditions of participation (CoPs) for Medicare certified hospice providers, involvement of the primary physician is indicated. Current CoPs require that the hospice interdisciplinary group complete the patient's initial comprehensive assessment in consultation with the individual's attending physician (if any) within five days of the election of hospice. And the care plan developed by the hospice team must be done in consultation with the patient's attending physician.

As healthcare providers continue to work on creating a more seamless continuum of care from diagnosis through hospice, the need for patients and families to feel supported is critically important.

"All physicians who have cared for a person during a life-limiting illness should continue to be a part of the patient's journey at the end of life. While the primary physician's role will change, his or her involvement should not stop when hospice starts," Schumacher noted.

Recognizing the importance of supporting families, hospices offer bereavement services to family members for a year after the death of their loved one.

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