AMA House of Delegates

Colette Willins, MD, says advanced care planning needs to be discussed, but not at every visit. Photo by Ted Grudzinski / AMA

AMA meeting: Advanced care plans should be discussed

■ AMA policy says physicians need to talk with patients about their wishes in the event of a serious illness or injury.

By Carolyne Krupa — Posted Nov. 22, 2010

San Diego -- Unexpected illness or injury can strike people of all ages at any time.

That's why physicians routinely should talk with all patients about their wishes in the event of a serious medical situation, says a new policy adopted at the American Medical Association House of Delegates Interim Meeting.

Doctors should encourage patients to discuss plans with loved ones and identify someone to make decisions for them if they became unable to speak for themselves.

Patients and families want to have these conversations, "but they want us to initiate it," said H.R. Greene, MD, an oncologist from Elida, Ohio, and member of the AMA Council on Ethical and Judicial Affairs. "If it's initiated, the suffering of all parties is minimized."

Physicians should be prepared to answer patients' questions and make notes as part of medical records, the policy says.

Though it's important to discuss advanced care planning with patients, it is not something that should be discussed with every patient on every visit, said Colette Willins, MD, a delegate for the American Academy of Family Physicians from Westlake, Ohio. "This is not something I would discuss at a two-year child wellness check."

When delivering a negative prognosis, physicians should be cognizant of where and how they deliver the news, and make sure patients get the information they need, said Jeff N. Stoneberg, DO, clinical medical director for the Institute for Palliative Medicine at San Diego Hospice. He was a featured speaker Nov. 8 at a CEJA educational session on advanced care planning.

Talking with patients about their goals and values will help them maintain a high quality of life as long as possible, he said.

ADDITIONAL INFORMATION

Meeting notes: Other actions

Issue: Excessive medical school debts place a large burden on physicians, affect choices and narrow the pool of medical school applicants. Some cities have considered imposing tuition taxes.

Proposed action: Oppose medical school tuition taxes and any other attendance-based taxes imposed on medical students by government. [Adopted]

Issue: Physicians and other health care workers have a professional obligation to safeguard colleagues, the public and themselves against preventable communicable diseases.

Proposed action: Promote physician immunization against vaccine-preventable diseases, as well as immunization of health care workers against seasonal and pandemic influenza. [Adopted]

Issue: Medical students are often restricted from accessing patients' electronic medical records, limiting educational and patient care opportunities.

Proposed action: Encourage teaching hospitals and other clinical clerkship sites to allow medical students access to patient electronic medical records. [Adopted]

Issue: Existing physician licensure procedures make it difficult for doctors who want to volunteer short term in other states.

Proposed action: Encourage the Federation of State Medical Boards to develop a process by which licensing boards would allow licensed physicians to volunteer for less than 90 days in another area. [Adopted]

AMA House of Delegates

AMA meeting: Advanced care plans should be discussed

■ AMA policy says physicians need to talk with patients about their wishes in the event of a serious illness or injury.

ADDITIONAL INFORMATION

Meeting notes: Other actions

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