Physician-related factors concerning treatment limitations

Abstract

Discussing patient preferences regarding treatment limitations is important for patient-centered care. This leads to higher satisfaction among patients, lower rates of anxiety of family members and lower health care costs. However, most physicians found it hard to initiate these conversations with their patients and therefore it is common for physicians to avoid them. The aim of this qualitative study was to examine the perspectives of physicians regarding the discussion of treatment limitations and the factors that might influence them in discussing treatment limitations at the outpatient clinic. Besides that, it examined if a communication training affects the physicians in their discussions about treatment limitations. Therefore, physicians were observed during consultations with patients at the outpatient clinic, both before and after they participated in a communication training about treatment limitations. Barriers that were found included practical barriers, like a lack of time and personal barriers, like a different cultural background. Facilitators that were found included a more informed patient and agreement on criteria. This study confirmed prior research that treatment limitations were discussed in a minority of the consultations at the outpatient clinic. The communication training was especially helpful because it created awareness about this topic, the physicians received feedback from colleagues and for recognition between the colleagues.