Prognosticating

Hospice: Prognosticating

Sharing Hospice Knowledge with Physicians.

I’d never heard of it before reading it today in a New York Times article.  Prognosticating: (verb) to foretell from signs or symptoms.It makes sense. You give a prognosis. To go through the process of identifying a prognosis is prognosticating.

The New York Times article “Why Doctors Can’t Predict How Long a Patient Will Live” talks at length about the challenges physicians face today in identifying a prognosis for a patient. In the past I’ve often considered that physicians are educated for so many years on how to save lives. Education on what to do when curative measures are not desired, or aren’t working, aren’t front and center stage.

Referring patients prior to end of life being imminent is something we all strive for in the hospice community. We want an opportunity to help patients and families receive the maximum benefits from the program. When patients are referred with just a couple of days, or even hours, left before passing, the ability to have an impact is reduced.

This article was very timely for me as I’ve been thinking about a blog article I’d read about a month ago written by a Medical Director at a hospice. He talked about being in an IDT meeting and seeing a patient’s name for the first time. The name of a person who had passed away. My initial thought was, “How could that be? Why don’t you know your patients?”  Then it dawned on me. He didn’t know the patient because their length of stay was so short with the hospice. He went on to say that every week when inevitably one such name would appear, his heart would be heavy. They hadn’t had an opportunity to make the impact with the patient or the family that he knew was possible.

How do we fix this?  My initial thought was educating the physicians on the benefit of hospice. I still think that this would be valuable but as I read the NY Times article I realized that’s a smaller part of a larger problem. The larger issue is that there’s no real help for physicians in identifying a prognosis. We focus on cures, medications and such to great length, thankfully, but we don’t have solid research to help them with identifying a prognosis.

How can we, in the hospice community, help share what we know with physicians? We see end of life often…

Are there predictors and research that you think the hospice community can feed “up” to physicians to help them?

January 23, 2012
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