Physicians' predictions of elderly outpatients' preferences for life-sustaining treatment.

BACKGROUND

Research has shown that physicians are poor predictors of patients' life-sustaining treatment preferences. Our study examined the 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 conditions.

METHODS

Seventeen physicians predicted the treatment preferences of 57 patients and then interviewed patients regarding their actual treatment preferences. Physicians' professional experience, length of their relationship with the patient, and experience with direct feedback were measured to determine the association of these factors with the accuracy of the physicians' predictions.

RESULTS

Physicians became more 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' preferences (P < .05).

CONCLUSIONS

Increased experience with life-sustaining treatment discussions improved the physicians' abilities to accurately 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' predictions. Future research should examine whether discussing end-of-life issues with patients more often makes physicians more sensitive predictors of patients' life-sustaining treatment preferences.