Fear of Physician Abandoment Affects Dying Patients

Kathleen Blanchard's picture
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A new study from an oncology physician at Seattle Cancer Care Alliance shows that dying patients, caregivers, and family members feel abandoned by their physicians. Patients report feelings of abandonment as death nears, and caregivers feel a sense of “unfinished business” after the patient dies.

Anthony Back, M.D., an expert on patient and physician communication, and lead study author says, "Doctors often don't realize how important this issue is for patients and their families. Something as simple as a phone call can go a long way toward allaying abandonment concerns”. Physician abandonment fears among caregivers and dying patients begins early, as dependency on physician expertise, and caring blossoms.

The report, published in the Archives of Internal Medicine, contains quotes from dying patients asked to share their perception of physician-patient relationship at end of life. One patient writes, "I think that it's important that you still have that contact with them even though there isn't anything they can do to make you better." The study shows that even though patients may be dying, they still rely on contact with their physician.

The paper, titled “Abandonment at the End of Life from Patient, Caregiver, Nurse and Physician Perspectives," contains direct quotes from patients about fears of abandonment by the physician, as well as ways that nurses and physicians can better meet the needs of dying patients.

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Suggestions from Dr. Back and colleagues include telephone contact, and verbal reassurance. Telephone contact should be maintained as death approaches, and visits to the physician become impossible. A simple call to the family or caregiver from the physician can provide an important sense of closure when a patient dies.

Dr. Back says the study is important because …”it provides empirical grounding for a central professional value of non-abandonment."

Fifty-five patients, thirty-five nurses, 36 family members or caregivers, and 31 oncologists, pulmonologists and general internists were recruited for the study.

The results show that verbal reassurance from physicians, availability for patient contact, and telephone calls as death nears, can help dying patients overcome fear of physician abandonment, and provide necessary closure to families and caregivers after a patient dies.

http://archinte.ama-assn.org/cgi/content/short/169/5/474

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