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Brief report: Identifying a proxy for health care as part of routine medical inquiry

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Abstract

BACKGROUND: Physician-initiated advance care planning is desirable, effective, and routinely indicated for competent adult patients, but doctors are often reluctant to begin the necessary conversations.

OBJECTIVE: To determine whether patients are willing and able to designate a surrogate for medical decision making, when asked to do so as part of routine medical inquiry.

DESIGN, PATIENTS, MEASUREMENTS: A survey asking patients to name a health care agent was designed and administered in the context of routine clinical care. Participants were drawn from a consecutive sample of 309 competent adult outpatients. Data were analyzed using ordinary descriptive statistics.

RESULTS: Two hundred ninety-eight of 309 patients (response rate, 96%) completed the survey and were willing and able to specify a proxy for health care. One third of married participants did not choose their spouse as proxy.

CONCLUSIONS: Asking patients to identify a surrogate for medical decision making opens the door for ongoing individualized medical care planning in the context of ordinary patient-physician interaction. This approach is applicable to all competent adults. Documenting proxy choice protects a patient’s wishes and preferences until more definitive planning is accomplished.

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Authors and Affiliations

  1. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    K. Michael Lipkin MD

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  1. K. Michael Lipkin MD
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Correspondence to K. Michael Lipkin MD.

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The author has no funding sources and no conflicts of interest to report.

A paper based on this investigation was presented as:

Jump Starting Advance Care Planning in the Context of Standard Medical Treatment: A Return to Basics

K. Michael Lipkin, MD; Nina Lipkin, MA

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Lipkin, K.M. Brief report: Identifying a proxy for health care as part of routine medical inquiry. J Gen Intern Med 21, 1188–1191 (2006). https://doi.org/10.1111/j.1525-1497.2006.00570.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00570.x

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