Prescribing the end-of-life conversation: Dr A. Volandes

It is a treat to see more and more articles in major publications outlining the need to talk about death and dying. The more we talk about it, the easier it gets.

If doctors (and patients) could see 'not knowing the patient's goals of care' as a problem as in need of urgent solving as 'the right-lower quadrant is tender,' 'the rhythm is v. tach,' or 'the potassium is 1.8' then we would all certainly be better off.

Read Dr Volandes take, subtitled: "Is saving the life of a terminal patient always the best medicine", in the Boston Globe.


Achieving optimal prescribing: What can physicians do?

Dr Sam Shortt offers direction and a call to action for physicians to achieve optimal prescribing patterns.

Some drugs are prescribed more frequently than is appropriate. Antibiotics, for example, are often prescribed for children with minor respiratory illnesses that are likely viral in origin. The underuse of clinically indicated medication is another type of suboptimal prescribing. Canadian studies have shown underuse of lipid-lowering agents, blood pressure drugs, medications for congestive heart failure, and prescriptions for post–myocardial infarction care. Finally, practitioners might make incorrect drug choices that might result in harm to patients.

Read more in CFP.