A chat with Atul Gawande about the craft of writing, mortality, and the organization of geriatric care

Atul Gawande’s best-seller, Being Mortal, has touched a nerve regarding our medical system’s poor handling of aging, life-altering illnesses, hospice, and palliative care. His book raises the question of why the U.S. health system prizes the length of a patient’s life over the quality of that life in a person’s final years. I caught up with Gawande for the Washington Post’s Wonkblog after he delivered a public lecture at the University of Chicago Medical Center.

Copyright Tim Llewellyn
Copyright Tim Llewellyn

He had done many interviews before mine. To tell you the truth, I worried that the interview would re-hash much that had come before.  In the event, we had a nice talk, which was a little different from the interviews he did with journalists who do not operate in medical or public health settings. I hope you enjoy it–more here.

What discharges alive from hospice tell us

(cross posted at freeforall)

Paula Span recently wrote about hospice as a shield against unwanted medical treatments that provided the space for an elderly Medicare beneficiary to get better. The irony is that the family she writes about had to choose the option associated with imminent death to be able to take their mother home and allow her to receive competent care that her adult children could trust; eventually, she was discharged alive from hospice. Work that I did with colleagues at Duke shows that around 15% of Medicare beneficiaries who begin hospice are discharged alive (85% of Medicare beneficiaries choosing hospice used such care continuously until their death, an average of 50 days later; median 15 days, Group 1 below).

Continue reading “What discharges alive from hospice tell us”