I’m a Hospice Physician. There’s One Thing I Dread Telling My Patients.

The medical examiner said, “But They Are Dying.” Hospice physicians like me often cannot provide patients with the necessary care they need.

Tom, who had metastatic cancer, was struggling at home as his condition worsened. His wife, Sue, was overwhelmed trying to manage his symptoms and needs. As a hospice physician, I suggested transferring Tom to an inpatient hospice facility for better care. Sue initially hesitated but eventually saw the benefits of the facility, where Tom received the care he needed to be comfortable.

Inpatient hospice facilities offer a warm and comforting environment for terminally ill patients. Unlike routine hospice care, which relies heavily on family caregivers, inpatient facilities provide round-the-clock professional care. However, access to inpatient hospice care is limited due to costs and specific criteria set by Medicare.

I work with patients under routine hospice care, but I believe continuous attention in inpatient facilities offers a better experience for patients and their loved ones. Unfortunately, most hospice patients do not have access to inpatient care, leading to challenges in managing end-of-life care effectively.

The current healthcare system prioritizes fee-for-service, focusing on procedures and interventions rather than holistic end-of-life care. Medicare covering inpatient hospice care would enhance the end-of-life experience by providing interdisciplinary support for patients and their families. The compassionate care Tom received in his final days should be standard practice for all individuals at the end of life.