Doctors Die Differently
Posted by Jim Kupel
In recent weeks three things each suggested to me that we need to do a much better job of learning how to die with dignity and peace.
The first was a get together with about 20 high school and college friends. Virtually everyone there was dealing with complications of aging relatives. That wasn't surprising because on-average over 6,500 Americans are dying every day according to the CDC. What was surprising is that everyone's process was different. It begged the question: why isn't there a "best practice approach" to the end-of-life journey? Of if there is one, why isn't it more widely shared?
The second interesting item was from a recent IHI Triple Aim conference. In addition to lots of inspiring and practical information, the presenters supported their observations with good data. In a somewhat detailed discussion about the difference between measuring DFLE (Disability-free Life Expectancy) and LF (life expectancy), Kevin Nolan noted that the gap between the two had actually widened from 5.4 years to 7.0 years in a United Kingdom study. In other words, Brits are living longer but this equates to more years with "long-standing illness, disability or infirmity." Great. Can it be much different in the U.S.?
Finally, I read with interest a great piece on Why Doctors Die Differently in the Wall Street Journal by Ken Murray. In it Dr. Murray suggests "Doctor's don't want to die any more than anyone else does. But they have usually talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken." The approach described by Dr. Murray and his cousin, was also free of serious pain, high-spirited and, oh by the way, cost less.
Why spend more as a nation to have additional disability-racked years and heroic measures that don't add meaning to our lives? And if we are to change the current paradigm, where do we start? A simple step is to talk about the issue.
IHI - http://www.ihi.org/offerings/initiatives/tripleaim/Pages/default.aspx
WSJ - http://online.wsj.com/article/SB10001424052970203918304577243321242833962.html