End of life discussions with patients can be incredibly difficult for physicians. Some view it as a failure; the care they provided was not enough to save the patient’s life, not considering factor such as the illness, condition or patient age. For others having these discussions is simply too uncomfortable to stomach.

These conversations are not just limited to specialties such as oncology or neurology where patients often have conditions too far advanced to effectively treat. They’re for physicians of all specialties. Primary care physicians perhaps have the most difficult of these conversations due to the long-lasting trust and deep relationships they build with their patients over many years and decades. Studies show that over 82.5% of patients want to have advance care planning discussions with their physicians, though only 24% report having had these conversations. 43.5% prefer to have them with their primary care providers and an overwhelming 94% wish these discussions happened early. Despite patients preferring to get advance care advice from their physicians, we don’t have these conversations often enough.

Keep reading for 4 reasons advance care plans are better for patients.

1. They get to guide their end of life care in accordance with their own values
   The same study referenced above found that preventing others’ values from guiding end of life care was a high priority for patients. American culture does, after all, greatly value individuality and freedom of choice. Creating an advanced care plan allows providers to deliver end of life care that is consistent with the patients’ values and preferences. Moreover, these documents should be updated regularly, as patients grow older, develop and change.

2. It gives patients more control
   There are certain advance directives that must be completed for advance care planning. Physicians should initiate these conversations and help patients fill out these documents and direct them on how to enlist supportive services. Doing this early on will allow patients more control over how their end of life care is performed.

3. Reduces healthcare costs
   With patients becoming more aware of healthcare over time, along with the development and advancement seen over the past few decades in pharmaceuticals and diagnosis, older generation such as baby boomers are living longer than those that came before. While longer lifespans are undoubtedly a good thing, caring for these older patients is not cheap; approximately 10,00 baby boomers enlist in Medicare on a daily basis and Medicare spending grew to over $900 billion in 2020. One third of that budget is spent on patients in the last months of their life. These costs can be saved by introducing patients to other options for end of life care that do not involve expensive hospital care. Allowing them to choose what they want will be better for all.

4. Physicians can earn
   Beginning on January 1^st 2016, physicians with the proper documentation whose advanced care planning conversations meet the criteria can now use billing codes 99497 and 99498 to get paid for having these discussions. This added incentive has made having these discussions beneficial to all involved.