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Making advance planning part of doctor visits

New York residents may be aware of a Medicare policy that reimburses doctors for holding end-of-life counseling sessions with their patients. However, many physicians are still reluctant to speak on the subject because of their reluctance or a lack of training. Medicare will reimburse physicians $86 for holding advance care planning sessions up to 30 minutes long. Doctor's assistants and nurse practitioners will also receive pay for counseling their patients, which can be done in hospitals or during routine visits to doctor's offices.

More Americans are showing an interest in making plans for their end-of-life care issues, especially in the event they become incapacitated and cannot express their wishes about whether or not they want to prolong their life with things like feeding tubes and ventilators. In fact, nearly 90 percent of people who were polled in a 2015 survey agreed that physicians should hold advance planning conversations with their patients.

In 2014, the Institute of Medicine recommended that insurers reimburse providers who discuss advance care planning with their patients. To prepare physicians to properly handle such challenging conversations with their patients, many medical schools are now offering educational programs about advance care planning. Once physicians feel confident and comfortable speaking on the subject, there may be more of them willing to go through with the counseling.

Those who have concerns about end-of-life issues such as advance health care directives might find answers via the advice of an attorney who has estate planning experience. The attorney can assist with the preparation of a living will as well as powers of attorney that can appoint a trusted person to make certain decisions when the principal becomes unable to do so.

Source: Medcity News, "Even with reimbursement, MDs still reticent about advance planning conversations with patients", Phil Galewitz, March 17, 2016

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