Most physicians know about hospice. If you are a physician and you want more information about hospice, it is available from the National Hospice & Palliative Care Organization , medical societies, state hospice organizations, or the National Hospice Help line, 1-800-658-8898. In addition, the American Cancer Society, the American Association of Retired Persons, and the Social Security Administration can help to provide information on Hospice.

Once you have referred your patient to hospice, you maintain your role of attending physician and become a member of the home care team. You sign the initial certification order, review the hospice plan of care, prescribe medication for comfort care, schedule clinic visits, and sign the death certificate. The hospice nurse or medical director will be in regular contact regarding pain and symptom management, changes in the patient's condition and any needed visits or phone calls.

Make sure your patient knows that you will continue to see them, and that you will help determine the best care possible. By demonstrating how you will work in partnership with hospice, you can reassure both patient and family that moving into a palliative treatment plan can be a positive step.

There is no one moment when a patient's condition suddenly makes him or her hospice-appropriate. The course of an illness can be quick or gradual, and both physician and patient need to understand the reasons behind a referral to hospice.