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A Nov. 3 MedPage Today opinion article argues that health practices should make advance-care planning easier and raise it with patients before a crisis. The author links the proposal to an aging population and too few geriatricians, but the piece does not present new workforce data or a formal policy announcement.
A MedPage Today opinion article published Nov. 3 calls on health practices to make advance-care planning a routine part of care, arguing that patients’ end-of-life preferences should be recorded before a serious illness makes decisions urgent. The proposal comes amid the author’s concern that the United States has too few geriatricians to meet the needs of its aging population; the article is commentary, not a new government policy or workforce assessment.
The contributor, identified as a MedPage Today contributing writer, argues that primary care teams and other providers should help fill gaps in care for older adults while the supply of geriatric specialists remains inadequate. The article says many older people remain healthy, while others face chronic illness, frailty or terminal diagnoses that can require difficult care decisions. It offers no count of the current geriatrician workforce or estimate of the shortage.
The proposed changes focus on starting conversations earlier and making patients’ wishes easier to find. The writer suggests asking about advance directives when people first join a practice, allowing them to upload existing documents, and giving patients who lack them forms and educational materials. Examples named in the article include a living will, a medical power of attorney and a Medical Order for Life-Sustaining Treatment, or MOLST, form.
The article contrasts those suggestions with the current workflow described by its author: patients complete multiple intake and screening forms, while questions about advance directives may appear only at a Medicare Annual Wellness Visit. The writer also says processes for arranging hospice, completing MOLST forms and accessing New York State’s Medical Aid in Dying program can feel unnecessarily complicated. These are the author’s observations and recommendations; the article does not report a survey of practices or a review of those processes.
Planning Before a Medical Crisis
Advance-care planning can help patients communicate their preferences and give family members and clinicians a record to consult when a person cannot speak for themselves. The article’s central concern is that waiting until a severe or terminal illness is diagnosed can leave too little time for clear discussion. Family members may disagree about what a patient wanted, the writer warns, though the article does not provide case data to quantify how often that occurs.
The recommendation also addresses a practical continuity problem: even when patients have completed documents, providers may not have them readily available. A routine process for collecting and updating those records could make preferences easier for care teams to locate. The potential benefit depends on patients being able to make informed choices, documents being kept current, and clinicians having systems that respect and apply those choices.
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A Proposed Role for Primary Care
The article frames its argument around two related concerns: an aging U.S. population and a limited supply of physicians specializing in geriatrics. It says the country needs more primary care doctors as well as many more geriatricians, and contrasts geriatrics with higher-paying specialties that, in the author’s view, attract more trainees. No comparative specialty enrollment figures are supplied.
Rather than treating advance-care planning as a task reserved for geriatricians or a late-stage Medicare visit, the writer proposes that other parts of the health system help with it. The suggestion is to make discussions and documentation part of patients’ interactions with providers, while leaving room for people to revise their plans as their health or circumstances change. The article does not set out a specific implementation plan, funding model or legal standard.
“Geriatricians are masters of this stuff, but until a time where we have thousands more who can help take care of patients during these challenging moments as they approach the end of their lives, we should build up stronger, better, and more respectful systems.”
— MedPage Today contributing writer, in the Nov. 3 opinion article
Workforce Data and Implementation
The opinion article does not provide workforce figures, patient data or independent research to establish the size of the geriatrician shortage or measure the effects of its proposed changes. It also does not identify a health system, regulator or professional body that has adopted the recommendations. The writer’s descriptions of paperwork and clinical workflow reflect the article’s account, not a documented national assessment.
It remains unclear how practices would fund staff time for these discussions, how they would protect privacy and keep documents current, or how a standardized intake process would accommodate patients who do not want to complete directives. The article advocates reducing administrative obstacles but does not specify which rules or safeguards should change. Requirements for care-planning documents and medical aid in dying can vary by jurisdiction and situation; the commentary does not analyze those differences.
Whether Practices Adopt the Approach
The article announces no formal next step, deadline or policy proposal. Its recommendations would require decisions by individual practices, health systems and, potentially, lawmakers or regulators. Readers can expect further developments only if those organizations publish plans, change intake procedures or revise guidance on advance-care planning.
For now, the immediate development is the contributor’s call for earlier conversations and more accessible documentation, rather than a confirmed change in how patients receive care. Whether such steps become routine, and whether they improve access to patients’ stated preferences, remains to be established.
Key Questions
What is the news in “Pinch Hitting for the Geriatricians”?
A MedPage Today opinion article urges health practices to discuss and record end-of-life preferences earlier, with help from primary care teams and other providers. It does not announce a new law or health-system policy.
What does the author recommend practices do?
The writer suggests asking about advance directives when patients join a practice, collecting existing documents, and offering forms and educational materials to people who do not have them. The article names living wills, medical powers of attorney and MOLST forms as examples.
Why does the article focus on geriatricians?
The author says the United States needs many more geriatricians as its population ages, and argues that other clinicians should help address older patients’ needs in the meantime. The article does not provide workforce data to quantify the shortage.
Has the proposal been adopted as policy?
No adoption is reported. The piece is commentary offering recommendations, and it names no health system or government body that has put them into effect.
What remains unknown?
The article does not establish how widespread the described workflow problems are, how much the recommended changes would cost, or what effects they would have on care. It also does not identify specific administrative rules to change.
Source: medpagetoday.com
