Hospice and palliative care: Attitudes and practices of the physician faculty of an academic hospital

Abstract

It has been suggested that physicians, particularly in academic hospitals, are resistant to the hospice approach to palliative care for terminally ill patients. It is of interest, therefore, to assess the attitudes and practices of the physician faculty of an academic hospital where a hospice program has been in existence for more than 10 years. This was assessed with two faculty surveys. All 966 physician faculty that were on staff at Northwestern Memorial Hospital in thefall of 1993 were sent a survey about their opinion of hospice care (Survey A). Then, all physicians who had referred patients to the hospice program between September 1993 and September 1994 at Northwestern Memorial Hospital received a survey letter after the death of their patient (Survey B). Seventy-seven percent of faculty physician respondents to Survey A had either referred patients, or knew of colleagues who had referred patients to a hospice program. Ninetyfour percent of those who answered “yes” to the question about referrals reported satisfaction with their care. Ninety-four percent would refer patients in the future and 96 percent thought the hospice program was a valuable resource to the medical center Of the respondents to Survey B, nearly 100 percent thought the referral had been handled in an “excellent”or “good”fashion, that communication with hospice staff was “excellent” or “good, “that symptom control was “excellent” or “good,” that their patients and families had received “excellent” or “good” psychosocial support, and that their patients and families were satisfied with the hospice care they received. When asked if their patients could have benefited from earlier referral, 29 percent said “definitely, ” 30 percent said “possibly,” 13 percent responded “doubtful” and 26 percent responded “no.” When asked if they would refer another patient to the hospice program, 95 percent responded “definitely” and 5 percent responded “possibly.” We conclude that a hospice program can be effectively utilized and valued by the attending physician faculty at an academic medical center