Physician knowledge, attitude, and experience with advance care planning, palliative care, and hospice: results of a primary care survey

Am J Hosp Palliat Care. 2013 Aug;30(5):419-24. doi: 10.1177/1049909112452467. Epub 2012 Jul 12.


Purpose: To evaluate primary care physicians' understanding of and experience with advance care planning (ACP), palliative care, and hospice and how this might affect their utilization of these services.

Methods: Investigator-generated survey.

Results: Older age, more years in practice, and more personal and professional experience with ACP were correlated with an increase in the percentage of patients with progressive, chronic life-limiting diseases with whom physicians discussed advance directives. Overall, 97.5% of physician's expressed comfort in discussing ACP yet reported discussing advance directives with only 43% of appropriate patients.

Discussion: Often, discussions about ACP or referrals to palliative care or hospice do not occur until the patient is near the end of life. Our results indicate that primary care physician's personal and professional experience with ACP may be contributing to some of the barriers to these discussions.

Keywords: advance care planning; barriers; hospice; palliative care; primary care; survey.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advance Care Planning / statistics & numerical data*
  • Age Factors
  • Aged
  • Attitude of Health Personnel
  • Data Collection
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hospice Care / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Ohio / epidemiology
  • Palliative Care / statistics & numerical data*
  • Physician-Patient Relations
  • Physicians / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Terminal Care / statistics & numerical data