title: Primary palliative care for the general internist: integrating goals of care discussions into the outpatient setting.
abstract: BACKGROUND
  Primary palliative care consists of the palliative care competencies required of all primary care clinicians. Included in these competencies is the ability to assist patients and their families in establishing appropriate goals of care. Goals of care help patients and their families understand the patient's illness and its trajectory and facilitate medical care decisions consistent with the patient's values and goals. General internists and family medicine physicians in primary care are central to getting patients to articulate their goals of care and to have these documented in the medical record.
  
  
  METHODS
  Here we present the case of a 71-year-old male patient with chronic obstructive pulmonary disorder, congestive heart failure, and newly diagnosed Alzheimer dementia to model pertinent end-of-life care communication and discuss practical tips on how to incorporate it into practice.
  
  
  CONCLUSIONS
  General internists and family medicine practitioners in primary care are central to eliciting patients' goals of care and achieving optimal end-of-life outcomes for their patients.
authors.affiliation: The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Chad L
authors.initials: CL
authors.lastname: Ahia
authors.affiliation: The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA ; Section of Palliative Medicine, Department of Pulmonary and Critical Care Medicine, and Department of Infectious Disease, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Blais
keywords: Advance care planning; advance directives; palliative care; patient care planning; primary care physicians