PHYSICIAN MANAGEMENT GUIDELINES FOR ADVANCE DIRECTIVES WITH PATIENTS

There is growing concern regarding the proper implementation of advanc e directives. A workable model for physicians to use with patients alo ng with appropriate guidelines is discussed in the context of the phys ician-patient relationship. Examined are variables involved in the est ablishment of guidelines for use by the physician in the office practi ce and inpatient settings. Key management and clinical factors for ini tiating and implementing an advance directive are identified for the p racticing physician. Responsibility for the initiation of education re garding the advanced directive is discussed from the patient perspecti ve. Effective use of advance directives with patients requires that a physician have an adequate knowledge base to appropriately guide the p atient throughout the treatment process, and that any efforts are coor dinated with other healthcare providers.