US Physicians Overwhelmingly Endorse Hospice as the Better Option for Most Patients at the End of Life

Abstract

Background: Utilization of hospice has increased significantly over the past 2 decades, but there has been no recent assessment of US physicians’ opinions regarding and practices of referring patients to hospice. Methods: We surveyed 2016 US physicians from various specialties. Respondents agreed or disagreed with 2 statements: “For most patients, hospice provides better care at the end of life than they would otherwise receive without hospice” and “Many patients who enter hospice end up missing out on medical interventions from which they would have benefited.” Physicians were also asked, “In the past 12 months, approximately how many patients and/or their surrogates have you encouraged to consider entering hospice?” Results: Ninety-eight percent of physicians agreed that hospice provides better care at the end of life than the patient would receive without hospice. Only 11% of physicians agreed that patients who enter hospice miss out on medical interventions from which they would have benefitted. Ninety-two percent encouraged at least 1 patient to consider hospice in the previous 12 months. Oncologists were the most ambivalent about whether patients who enter hospice miss out on beneficial interventions, but they also referred more patients to hospice than physicians from other specialties. Conclusion: US physicians overwhelmingly believe hospice is the best form of care for most patients at the end of life. Compared to a study published in 1998, the median oncologist reports referring fewer patients to hospice, but the median general internist reports referring more.