Improving physician communication skills in end-of-life care

Dr. Michael Gordon
Medical Program Director
Palliative Care, Baycrest

The July 15th, 2012 article in The Globe and Mail, Go gentle into that good night highlighted the importance of educating physicians at all levels of training and practice as to the challenges and satisfaction in communicating successfully with patients and families when end-of-life issues are looming. Although the focus was in the venue of intensive care, the principles are universal.

The current stage of my working life has focused on a combination of palliative and end-of-life care, with a special emphasis on dementia combined with an important interface with medical ethics. After three decades in geriatric medicine, and just prior to my retirement as Vice President of Medical Services and Head of Geriatrics at Baycrest, I agreed to “cover” the palliative care unit administratively for a limited period. That “limited” period lasted more than a year, and then as I retired from my “chief” positions I accepted the administrative supervisory role on the palliative care unit at Baycrest where I currently work. I had completed my masters in Ethics at the University of Toronto and began to shift the focus of my clinical practice to dementia. Those changes resulted in an emphasis on end-of-life discussions with patients and families which became a core part of my activities. I realized that the necessary skills and attitudes required to carry out this role were often inadequately addressed in medical education.

The Globe story highlighted a unique communications program that is helping to fill this gap, offered at Toronto General Hospital for doctors-in-training. Baycrest will also be hosting an educational workshop in this area later this fall. As a physician, I want to help families deal with the emotional tragedy and distress of knowing they are going to lose a loved one. I have tried to enhance the communication process by writing my latest book, Late Stage Dementia: Promoting Compassion, Comfort and Care, so that health care professionals as well as family members of ill loved ones understand there are many factors to consider when trying to achieve the goal of successful palliative care. I also encourage everyone who has an interest in this area to read the Globe article (linked above) by Carly Weeks.

Dr. Michael Gordon is a medical professor, ethicist and one of Canada’s best known geriatricians. His work to advance the understanding of aging and end-of-life care is valued by both public and professional audiences. Dr. Gordon explores and addresses the difficult questions of caring for the elderly with late-stage dementia in his latest book.