Talking Freely About What You Want
The goal is for patients to receive care in those final months that aligns with what the patient wants, even if that's the most aggressive treatment available. But it "turns out when you're able to have more effective decision making amongst the family and physicians, an individual often has values and priorities" that are met by palliative care instead of more treatment, according to Daitz.
And when these conversations do happen, there's can be another byproduct: reduced costs. Research is finding that when patients fully understand aggressive care, many choose less of it. By Daitz' own rough estimate, the company’s services have resulted in about $10,000 less in health care spending per patient, "$100 million to the health care system in 2014."
But some people are wary of the company's approach. Dr. Lauris Kaldjian, professor of bioethics at the University of Iowa, has concerns about the social worker, patient and family never actually meeting. "Because if you don’t have enough knowledge about what's actually going on with the patient, it would actually be irresponsible to pretend to have discussion that depends upon such knowledge."
End-of-life decisions are hard to keep totally neutral, he says, so that’s why he'd want full transparency from insurers and the company to guard against bias in the sessions.
Dr. Robert Arnold, who heads the palliative care division at the University of Pittsburgh Medical Center, says insurers may be well situated to address the communication disconnect, at least while providers work through their own discomfort and improve their skills. He sees companies like Vital Decisions as part of a larger trend.
"Would I prefer that we live in a health care systems where doctors, nurses, nurse practitioners and social workers who knew the patient were having these conversations? Yes," he says. "This is better than what patients have currently been getting."
Meanwhile, Vital Decisions' Daitz says he looks forward to the day when these conversations are taking place and his company is no longer needed.
More Articles
- Board of Governors of the Federal Reserve System Question: Design and the Gender Gap in Financial Literacy
- Medicare Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
- National Institutes of Health: Common Misconceptions About Vitamins and Minerals
- Julia Sneden Redux: Age Rage; Sometimes You Just Have to Strike Back
- Medical Billing and Collections Among Older Americans
- A Yale Medicine Doctor Explains How Naloxone, a Medication That Reverses an Opioid Overdose, Works
- Health, United States, 2020-2021: Annual Perspective; Focus of This Issue is On Health Disparities by Sex, Race, Ethnicity and Socioeconomic Status
- Kaiser Health News Research Roundup: Pan-Coronavirus Vaccine; Long Covid; Supplemental Vitamin D; Cell Movement
- How They Did It: Tampa Bay Times Reporters Expose High Airborne Lead Levels at Florida Recycling Factory
- Shhhhhh by Ferida Wolff