kwyattmd

I am sad to say that you are right to be suspicious. During my years as a hospice physician (I'm now retired) I saw a change occurring in the industry. When our own hospice was taken over by a for-profit company whose CEO was an MBA who knew nothing about medicine or hospice we suddenly started seeing a push to accept more non-terminal patients. After visiting several of the patients and concluding that they were not appropriate for hospice I refused to sign their certification papers. The CEO then decided that face-to-face visits with the physician were not necessary and urged me to sign papers based solely on the recommendations of the new nurse he had hired. Needless to say I did not remain employed by that company! The Medicare per diem is just too tempting for some business-minded CEO's to resist and there are not enough regulators to keep up with all the fraudulent cases. Even some non-profit hospices are now moving in this direction in order to stay competitive. However, that being said, there are still many reputable hospices out there. Watch for the good ones who value patient care over profit and recommend their services to your patients and families.

I am very impressed with this article and very much in agreement. As a family practice and hospice physician (now retired) I believe very strongly in the importance of addressing In fact I believe that much of our over-utilization of the medical system occurs when patients who are actually experiencing an unrecognized spiritual crisis (such as the search for meaning and purpose) are offered only diagnostic tests and drugs instead of the guidance and support they really need. Fragmented healthcare that fails to address the whole person is expensive, wasteful and ineffective. While our overall medical system is slow to recognize the spiritual changes that are needed, individual nurses and doctors who awaken to the need for a spiritual approach can begin to influence that system from the inside and make an enormous difference in their patients' lives. Thank you for addressing this issue.