It's incumbent upon physicians to help patients understand end-of-life care options, even though the coding and payment system for these discussions is lagging behind. Discussions about options have been shown to lessen depression, pain and anxiety for patients in their final days. A formal payment code would help in tracking such vital data.
Reply:
Recently proposed federal legislation on health reform would have allowed physicians to code and get paid for discussing end-of-life care options with patients. This idea was not welcomed; instead, it was met with alarm and bizarre misunderstanding -- the "death panel" inference and cries of "health care rationing." The provision has been removed from current reform bills.
The rationale behind the proposal was the assumption that allowing doctors to bill specifically for discussions about goals and advance directives for health care planning would motivate them to have those discussions. If this assumption is correct, then how do we convince the public that we are not trying to "pull the plug" on old people who get sick and are viewed by some as a drain on society's resources, but that advance planning discussions are in their best interest?
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