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New program seeks to encourage more of us to talk with our doctors about end of life care

University of Michigan Medical School

No matter what your circumstances in life, there is one great and final equalizer: Every single one of us will die.

Yet it is often difficult for patients, their families and their physicians to accept the approaching end of life and to shift focus of care from curing and treating to comfort.

But end of life issues are something most of us want to talk about.

A Kaiser Health Tracking Poll finds nine in ten of us want to have end of life discussions with our doctors, yet only 17% say they have had such a conversation.

An upcoming program could change that.

Starting January 1, the Centers for Medicare and Medicaid Services will reimburse physicians for having end of life conversations with patients and loved ones.

Dr. Adam Marks is the medical director of Arbor Palliative Care and an assistant professor of Internal Medicine at the University of Michigan.

Marks tells us the main reason so few of us have had those end of life conversations with our physicians is because before now, clinicians haven’t been reimbursed for that time.

“We know that doctors already have a lot on their plate,” he says. “Asking them to sit down to have a conversation about preferences for care at the end of life while not paying them for that time was a pretty tall order.”

On top of that, Marks says that those discussions are uncomfortable for the doctors as well, “because it means admitting that fact that all of us are going to die someday.”

Washtenaw Health Initiative Advance Care Planning co-chair Marianne Udow-Phillips tells us that regardless of how uncomfortable the conversation is, it’s important for both a patient and their family to make some decisions about the road ahead.

“Part of what we’re trying to emphasize is this isn’t actually just about when you’re dying, it’s about when you get a serious illness. Your family needs to understand what your preferences are. How do you want to be cared for? That’s what advance care planning is about, it’s about thinking about it now when you’re healthy or before you’re at your end of life,” Udow-Phillips says.

Dr. Adam Marks and Marianne Udow-Phillips tell us more about the options and resources available for patients making end of life decisions in our conversation above.

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