Docs see ill patients’ families as barrier to talking about care plan

By Kathryn Doyle Reuters Health - Doctors say that when patients are seriously ill, the main obstacles to discussing what the goals of care should be are family disagreement and patient denial. “But that means we need to be there with extra support and profoundly good skills.” In 2012 and 2013, You and his team surveyed more than 1,000 clinicians, including nurses, residents and staff physicians, at 13 university-based hospitals in Canada, asking them to rate the importance of 21 potential barriers to goals-of-care discussions with seriously ill hospitalized patients. Other obstacles, like physician lack of time, language barriers, lack of training and desire to avoid being sued, were rated as less important, according to results in JAMA Internal Medicine. “Are we in the medical field pointing the finger at patients?” asked Dr. James N. Kirkpatrick of the University of Pennsylvania in Philadelphia, who wrote an editorial about the study.



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