Physicians Less Likely to Request Surgery and Aggressive Care at End of Life

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Physicians are less likely to have surgery, die in a hospital, and be admitted to the ICU.
Physicians are less likely to have surgery, die in a hospital, and be admitted to the ICU.

(HealthDay News) — Physicians facing death are less likely to demand aggressive care, according to two research letters published in the Journal of the American Medical Association, a theme issue on death, dying, and end of life.

In the first study, Joel Weissman, PhD, deputy director and chief scientific officer of the Center for Surgery and Public Health at Brigham and Women's Hospital in Boston, and his colleagues reviewed data on Medicare beneficiaries aged 66 or older who died between 2004 and 2011 in Massachusetts, Michigan, Utah, and Vermont. The researchers assessed 5 measures of end-of-life care intensity during the last 6 months of the patients' lives. These included surgery, hospice care, intensive care unit (ICU) admission, death in the hospital, and the cost of care.

Compared with the general population, physicians were less likely to die in a hospital (27.9% vs 32.0%), less likely to have surgery (25.1% vs 27.6%), and less likely to be admitted to the ICU (25.8% vs 27.6%), the researchers found.

Saul Blecker, MD, an assistant professor of population health at the New York University School of Medicine in New York City, and his colleagues used data from a national mortality survey to compare the location of death for physicians with that of other health care professionals, people with higher education, and the general population. They found that physicians were slightly less likely to die in a hospital than the general population (38.3% vs 40.4%), but equally as likely to die in a hospital as others in health care professions or with similar levels of education. In addition, physicians were the least likely group to die at any sort of care facility: 63.3% for physicians, 65.4% for other health professionals, 66.1% for others with higher education, and 72.4% for all others.

References

Weissman JS, Cooper Z, Hyder JA, et al. End-of-Life Care Intensity for Physicians, Lawyers, and the General Population. JAMA. 2016;315(3):303-305. doi: 10.1001/jama.2015.17408.

Blecker S, Johnson NJ, Altekruse S, Horwitz LI. Association of Occupation as a Physician with Likelihood of Dying in a Hospital. JAMA. 2016;315(3):301-303. doi: 10.1001/jama.2015.16976.

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