Physician perspectives on end-of-life care: factors of race, specialty, and geography.
OBJECTIVE
To describe physicians' end-of-life practices, perceptions regarding end-of-life care and characterize differences based upon physician specialty and demographic characteristics. To illuminate physicians' perceptions about differences among their African-American and Caucasian patients' preferences for end-of-life care.


METHODS
Twenty-four African-American and 16 Caucasian physicians (N=40) participated in an in-person interview including 23 primary care physicians, 7 cardiologists, and 10 oncologists. Twenty-four practices were in urban areas and 16 were in rural counties.


RESULTS
Physicians perceived racial differences in preferences for end-of-life care between their Caucasian and African-American patients. Whereas oncologists and primary care physicians overwhelmingly reported having working relationships with hospice, only 57% of cardiologists reported having those contacts. African-American physicians were more likely than Caucasian physicians to perceive racial differences in their patients preferences for pain medication.


CONCLUSIONS
Demographic factors such as race of physician and patient may impact the provider's perspective on end-of-life care including processes of care and communication with patients.
Carter
Cindy L
CL
Cancer Center, Medical University of South Carolina, 86 Jonathan Lucas Street, Charleston, SC 29425, USA. cartercl@musc.edu
Zapka
Jane G
JG
O'Neill
Suzanne
S
DesHarnais
Susan
S
Hennessy
Winnie
W
Kurent
Jerome
J
Carter
Rickey
R
D000328:Adult; D001741:Black or African American / Q000523:psychology; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011365:Professional Practice Location; D013038:Specialization; D013727:Terminal Care; D044465:White People / Q000523:psychology