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Physician perspectives on end-of-life care: Factors of race, specialty, and geography

Published online by Cambridge University Press:  27 September 2006

CINDY L. CARTER ,
JANE G. ZAPKA ,
SUZANNE O'NEILL ,
SUSAN DesHARNAIS ,
WINNIE HENNESSY ,
JEROME KURENT  and
RICKEY CARTER
CINDY L. CARTER
Affiliation:
Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
JANE G. ZAPKA
Affiliation:
Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA
SUZANNE O'NEILL
Affiliation:
Department of Psychology, University of North Carolina, Chapel Hill, North Carolina, USA
SUSAN DesHARNAIS
Affiliation:
Institute for Health Services Research and Policy Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
WINNIE HENNESSY
Affiliation:
Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA
JEROME KURENT
Affiliation:
Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
RICKEY CARTER
Affiliation:
Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA
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Abstract

Objectives: 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.

Design and 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.

Significance of results: 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.

Keywords

Physician surveyPatient preferencesAfrican-AmericanEnd-of-lifePain management
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 3 , September 2006 , pp. 257 - 271
Copyright
© 2006 Cambridge University Press

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