Twenty years beyond medical school - Physicians' attitudes toward death and terminally ill patients

Background: In response to consumer demands and recent changes in health ca re, the American Medical Association and the Association of American Medica l Colleges have expressed concern about how physicians relate to patients, especially those who are seriously ill. Objective: To determine the impact of 20 years of medical practice on the a ttitudes of physicians toward terminally ill patients and their families. Methods: Data were gathered from questionnaires mailed in 1976 and again in 1996 to physicians who graduated from medical school between 1972 and 1975 . Results: Responses were received from 71% and 63% of the 1664 and 1109 phys icians surveyed in 1976 and 1996, respectively. Using a t test for paired v ariables, statistically significant differences were noted for physicians' responses to all of the 11 Likert-type attitudinal statements on death and terminally ill patients and their families. Physicians in 1996 were more wi lling to inform terminally ill patients of their prognosis and in general s eemed more confident with dying patients than they were in 1976. Conclusions: After 2 decades of practicing medicine, physicians' attitudes toward terminally ill patients seem to have changed; physicians appear to b e more open to communicating with terminally ill patients and their familie s on issues concerning death and dying.