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Advance Care Planning for the Medical Office

Advance Care Planning for the Medical Office


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Marjorie A. Bowman, MD, MPA, and Abi Katz, DO, MS
 
Death brings many emotions and processes for the dying individual and his or her caregivers and significant others. Advance care planning (ACP) for death has both legal and humanistic dimensions. The legal aspects include sanctioned legal documents about medical care for people who are no longer competent to make their own decisions. Equally important is the human side—the care planning in advance for death—that allows patients to make their own decisions in advance about their medical care at the time of their death. Careful ACP supports dying individuals and their families and reduces unwanted, unnecessary, and burdensome medical interventions and needless suffering and confusion. Such planning requires significant and timely ACP conversations. Physician offices are a major site of initiating (“triggering”) and undertaking ACP conversations, which have been encouraged by CMS-identified reimbursement codes.