Today we talk with Kim Vass-Eudy, Senior Director of Clinical Operations at CHESS and practicing Doctor of Osteopathic Medicine about the importance of Advanced Care Planning and strategies for starting those conversations.
Dr. Kim Vass-Eudy, welcome to the move to value podcast!
Thank you, Thomas, it's good to be here.
So today I want to discuss some things that I know are of great importance to you, which is advanced care planning. Can you tell me or tell us what that is and what it consists of?
Sure. It's basically a discussion with patients about their plans for their future. It's about what they want to do if something were to happen to them and they couldn't speak for themselves. It's about end of life care, in a lot of ways, making their wishes known. It's a discussion that can occur between a provider and their patient and their patient’s family members or someone that they want to make decisions about their care and it really outlines what their wishes are so that there's no guesswork, there's no stress at the end of life. That the patient’s wishes are known
That's fascinating. So, you are a practicing physician, and a darn good one from what I understand!
Thank you.
So how important do you deem advanced care planning in the care plan for your patients?
So I think it's essential. I think as providers, we're just not doing it enough. It's one of those things that they don't teach us about in medical school or in our training or at least I didn't have that education. I've been out about 16 years or so. So no one ever told me how to do this. The goal of being a doctor is to save people and to keep them alive for as long as possible, so having those discussions about end of life care feels very different and probably goes against what my teaching has been as a provider. So when they looked at, they actually asked patients and people if they're having these discussions with their primary care physicians or physicians in general, and 84% of Medicare age patients said that they've never had this discussion with their doctor and these are patients that are in the older generation so no one's talking to them about this. And they also polled Americans in general, so this is not just Medicare age patients but Americans in general said 92% of them said they'd like to have these kind of conversations, that they're interested in that, that they're willing to have those conversations with their patient or with their providers and and to discuss their wishes. 53% of that group said it would be a relief you know if someone would bring this up to them and have this discussion so that they don't have to think about it or talk about it, that they can start making decisions now about their future.
So in my practice you know I tend to do these discussions at well visits because that's when patients aren't thinking about anything but just being healthy. So I start saying to them, well what if something were to happen? What are your wishes have you talked about this with your family? And I think it's just as important as talking to them about diet, exercise, vaccines, cancer screening, and the you know one of the drawbacks though is this takes time. That's why I typically do this at the well visit because it takes a lot of time to have these discussions and I give myself about 30 minutes for those visits so I'm able to really discuss it with patients and answer their questions about it. You know for providers, there's a lot of issues because we're not trained and we don't have guidelines. No one tells us how to do this. Providers, one of the things that they say they're most fearful of even having these conversations because they don't want to destroy hope for people. They don't wanna tell them Oh yeah guess what you know the end is near and you better start thinking about it they don't want to take that hope...
