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Author Explores the Importance of "Getting It"


James C. Salwitz, an oncologist, writes on KevinMD about the importance of healthcare professionals who “get it” when it comes to hospice care. Hospice professionals easily spot those who don’t “get it,” says Salwitz. These are the physicians, he says, who “despite death lurking, just another complication away,” treat their patients “with maximal, aggressive, unrestrained care.” These physicians, he says, don’t “get it,” and fail to provide good care. Instead, such healthcare professionals “maximize suffering, compound confusion, amplify futile intervention and guarantee out-of-control costs that will bankrupt the family.” The family will bear the costs, says Salwitz, and care like this has “set up a ridiculous, unethical and incredibly common system of care.”

There is a second set of physicians who are “just beginning to ‘get it.’” And more and more physicians are falling into this group. These physicians, unlike those who do not “get it” at all, are engaged in more end-of-life consultations. They know patients die, but they “are not sure what to do about it.” These physicians are far more likely to refer patients out for palliative care and hospice consultations.

Physicians who “get it” offer frank and honest feedback to their patients and respect their patients’ rights to make their own choices. Says Salwitz, “‘It is your life. As your doctor, my job is to guide, not order or command. It is about you, not me. You are the patient. I am the teacher and healer.’” Because patients face increasingly available and confusing choices in care, he says, it is ever more important that physicians “get it.”

The ability to receive truth, and to be enabled and guided in making our own healthcare decisions is critical. Salwitz concludes, “Only by seizing those precious moments, deciding our own fate, can we hope for quality, comfort and dignity.”

Source: (Kevin MD, 5/24,