title: Hospice and primary care physicians: attitudes, knowledge, and barriers.
abstract: Underuse of hospice services is a significant problem in the United States. Primary care physicians constitute an increasing referral base and have been hypothesized to be important barriers to increased use. We conducted a mail survey of 131 primary care physicians (overall response rate of 72 percent), examining their attitudes toward, knowledge about, and perceived benefits and barriers to hospice care. Physicians demonstrated very favorable attitudes towards hospice. They had correct knowledge about most aspects of hospice, and, where they did not, they were far more likely to be uncertain than erroneous. Primary care physicians perceived many benefits to hospice care and identified patient and family readiness as the major barrier to earlier hospice referrals. A significant subgroup had concerns about problems in interacting with hospices. There were very few differences between family practitioners and general internists. These findings have many implications for directing collaborative efforts between primary care physicians and hospices to improve end-of-life care.
authors.affiliation: Program in Palliative Care Education and Research, and Department of Family Practice, Michigan State University, East Lansing, Michigan, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Ogle
authors.forename: Brian
authors.initials: B
authors.lastname: Mavis
authors.forename: Tammy
authors.initials: T
authors.lastname: Wang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002648:Child; D005194:Family Practice; D005260:Female; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D010821:Physicians, Family / Q000523:psychology*; D011320:Primary Health Care; D012017:Referral and Consultation; D014481:United States