Medicare, Hospice & Trustworthy Doctors

QUESTION: The doctor recommended hospice for my father today (89, congestive heart failure). I believe this is probably the right thing, but how do I know this isn't about money (his Medicare is running out)? Can I really trust the doctors?

I don’t know enough about your father’s individual medical situation to know if a hospice referral is appropriate but I can address your medicare comment.

Medicare Hospice has specific requirements for admission. There must be a life threatening illness where the doctors believe the person has less than six months to live. This requirement is difficult for physicians since no one can be so specific as to say exactly how long a person has to live. Congestive Heart Failure does reach a point where a person is not fixable, where the heart is just wearing out and medications are not working effectively. Congestive Heart Failure and the fact that your father is 89 years old leads me to believe that a hospice referral is appropriate.

Now to your concerns about money being a reason for the referral: A referring physician does not and should not receive any financial reimbursement for recommending hospice so I don’t see how money can be an incentive for recommending hospice services. Hospice Medical Directors can be on a hospice payroll but their job is to interact with patients and consult with referring physicians after a referral is made. The operative word here is “after” the referral is made.

“Can I really trust the doctors?” is again impossible for me to answer. I do not have enough personal information. From a general stand point I say “sometimes”. Sometimes we can trust people, doctors included, and sometimes we can’t. It is really up to us to ask pertinent, direct questions that require decisive answers. It is up to us to do our research about treatment options and treatment vs. non-treatment. We also need to research the credentials and reputation of all of the physicians involved in our care. Were they recommended to us because they work for and are paid by the same clinic or office that our primary physician is in? Are they golf buddies? Or is this a physician that has a reputation for excellence in the area we need. It is up to us to find these things out. It is up to us to take charge of our treatment and care. Yet, when it comes to medical care, we all to often place our trust in those that we really know nothing about.

Something more about Medicare, Hospice & Trustworthy Doctors...

A TIME TO LIVE, Living With A Life-Threatening Illness, offers guidelines to help one live fully with their gift of time. It is the booklet to give to one who has just entered hospice care and is looking for support.

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