PHYSICIANS PREDICTIONS OF ELDERLY OUTPATIENTS PREFERENCE FOR LIFE-SUSTAINING TREATMENT

Background. Research has shown that physicians are poor predictors of patients' fife-sustaining treatment preferences. Our study examined th e association between three aspects of physician experience and their ability to accurately predict patients' preferences for two different life-sustaining treatments in the event of two serious medical conditi ons. Methods. Seventeen physicians predicted the treatment preferences of 57 patients and then interviewed patients regarding their actual t reatment preferences. Physicians' professional experience, length of t heir relationship with the patient, and experience with direct feedbac k were measured to determine the association of these factors with the accuracy of the physicians' predictions. Results. Physicians became m ore accurate predictors as they interviewed more patients and received direct feedback regarding the accuracy of their predictions (P < .001 ). Residents were more accurate than faculty in predicting patients' p references (P < .05). Conclusions. Increased experience with life-sust aining treatment discussions improved the physicians' abilities to acc urately predict patient preferences. Although possibly resulting from small sample size, neither greater professional experience nor longer relationship with a patient improved the accuracy of physicians' predi ctions. Future research should examine whether discussing end-of-life issues with patients more often makes physicians more sensitive predic tors of patients' life-sustaining treatment preferences.