Do doctors, consumers agree about hospice?

Physicians say that hospice is great, but there's too little service, and it's offered too late. That's one of the top findings of a new national survey conducted to compare attitudes and perceptions about hospice care among consumers and physicians.

Consumers agree with physicians on the quality of hospice and the amount of service that should be provided. But when it comes to the right time to discuss hospice, it's an individual preference.

Quality of hospice in the United States is good to excellent say both groups. Respondents were asked to rate the quality of care received by their loved ones; 64% of consumers and 61% of physicians said the care was excellent.

As for length of service, physicians and consumers agree that patients should be receiving hospice care for at least 90 days, with most of the general public (54%) and physicians (52%) identifying six months or longer as the appropriate length of time. But half of hospice patients today receive care for less than three weeks, according to the National Hospice and Palliative Care Organization.

Though nearly everyone says they want more time in hospice, there are key differences between physicians and consumers when it comes to initiating the service. Sixty-two percent of doctors said that hospice in America is offered to patients too late. In contrast, 77% the general public said it was offered at the right time.

When asked about their own loved ones, one out of three consumers and physicians said they would like to start the hospice conversation at the time of diagnosis or the start of treatment. Yet only one out of five physicians actually starts the conversation then.

"Being ready to discuss hospice is clearly a very personal matter," says Perry Farmer, president of Crossroads Hospice, which commissioned the survey. "Sadly, many physicians and patients wait until all treatment options have been exhausted to even bring up the subject. Hospice care helps the terminally ill live the remainder of their lives with comfort and confidence. It's a godsend to many families."

Porter Storey, MD, FAAHPM, executive vice president of the American Academy of Hospice and Palliative Medicine, said he hopes the survey results will encourage doctors to make sure their patients know the benefits of this special type of medical care. "We've always known that patients start receiving hospice care late, missing out on months of symptom relief and the many other ways hospice care can improve quality of life for them and their families, but it's good to see that patients and doctors do appreciate its value and want to talk about it," he said.

The Hospice Care study is a comprehensive survey of adults and physicians across America. Respondents included 700 consumers age 35 and older and 300 physicians: 200 specialists and 100 primary care physicians. All respondents had some familiarity with hospice.