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Contempo 1997: End-of-Life Care

James Burke, MD; R. Knight Steel, MD
JAMA. 1997;278(14):1150-1151. doi:10.1001/jama.1997.03550140042032.
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To the Editor.  —In the end-of-life care article1 in the 1997 Contempo issue of JAMA, Drs Sulmasy and Lynn note that the current funding for health professionals' education does not require attention to end-of-life care. Yet opportunities to make a significant improvement in this area abound. Many hospices are closely associated with acute care institutions, and the present day cost-conscious health care system would seem to encourage hospice use for both patient care and physician education, as noted by Christakis and Escarce2 and others.3,4We surveyed (unpublished data, 1996) 782 chief executive officers of hospices that were listed as a division of a hospital according to records provided by the National Hospice Organization. Based on data from 280 responders, hospices were deemed to improve the public's perception of the affiliated hospital (91%) and to foster better pain management (86%). Yet the value of the hospice for both


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