Joanne Lynn, MD, MA, MS
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0137.
Lynn J.; The Doctor: For Life and at the End of Life. Ann Intern Med. 2015;162:804. doi: 10.7326/L15-5080-2
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Published: Ann Intern Med. 2015;162(11):804.
TO THE EDITOR:
Most persons in the United States will now die of multiple chronic conditions, with the timing of death being unclear until the last few days. Persons alive at 70 years of age face nearly 3 years of self-care disability in the last phase of their lives, with a series of private arrangements and health care supports. It seems that "palliative care" should not be mostly the province of specialists but a highly valued skill of virtually all physicians. Furthermore, it seems that Pizzo's comments (1) on the last part of life should focus more on nursing homes, home care, long-term care financing, continuity for persons living with disabilities associated with aging, and related topics. The Institute of Medicine report actually does address these issues, but they have not been discussed in the professional or public press.
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