Journal of General Internal Medicine

, Volume 27, Issue 10, pp 1287–1293

End-of-Life Care from the Perspective of Primary Care Providers

Original Research

ABSTRACT

PURPOSE

To explore the factors influencing primary care providers’ ability to care for their dying patients in Michigan.

METHODS

We conducted 16 focus groups to explore the provision of end-of-life care by 7 diverse primary care practices in southeast Michigan. Twenty-eight primary care providers and 22 clinical support staff participated in the study. Interviews were analyzed using thematic analysis.

RESULTS

Primary care providers (PCPs) wanted to care for their dying patients and felt largely competent to provide end-of-life care. They and their staff reported the presence of five structural factors that influenced their ability to do so: (1) continuity of care to help patients make treatment decisions and plan for the end of life; (2) scheduling flexibility and time with patients to address emergent needs, provide emotional support, and conduct meaningful end-of-life discussions; (3) information-sharing with outside providers and within the primary care practice; (4) coordination of care to address patients’ needs quickly; and (5) authority to act on behalf of their patients.

CONCLUSIONS

In order to provide end-of-life care, PCPs need structural supports within primary care for continuity of care, flexible scheduling, information-sharing, coordination of primary care, and protection of their authority.

KEY WORDS

primary care practice palliative care end of life qualitative 

Supplementary material

11606_2012_2088_MOESM1_ESM.doc (39 kb)
ESM 1Appendix (DOC 39 kb)

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Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  1. 1.Veterans Administration, Health Services Research and Development Center of ExcellenceAnn ArborUSA
  2. 2.Division of General Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborUSA

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