Practice patterns of osteopathic physicians providing end-of-life care: A survey-based study

Context: In 1996, the American Medical Association drafted and organized the Education for Physicians on End-of-Life Care (EPEC) curriculum. Leadership in the osteopathic medical profession has similarly recognized the goals of EPEC - resulting in the development of Osteopathic-EPEC, which incorporates the core tenets of osteopathic medicine. Objective: To assess the impact of EPEC training and the integration of osteopathic principles and practice in end-of-life care provided by osteopathic physicians (DOs). Methods: Osteopathic physicians who participated in the 2002 and 2003 AOA (American Osteopathic Association) End-of-Life Care - National Osteopathic Workshops were surveyed (N=100) on the use of advance directives and on their application of the tenets of osteopathic medicine, including the use of osteopathic manipulative techniques, for terminally ill patients. Results: More than 90% of responding DOs (n=66) ranked each of the four core tenets of osteopathic medicine as important. Among completed responses, 58 DOs (89%) said they believed the tenets and philosophy of osteopathic medicine better prepared them to provide end-of-life care. Forty-eight DOs (79%) agreed that the use of osteopathic diagnostic and treatment skills augmented their ability to provide quality care for terminally ill patients. Conclusion: Osteopathic physicians indicated that the tenets of osteopathic medicine improve their effectiveness in providing quality end-of-life care to patients. However, fewer than half of surveyed DOs who used osteopathic manipulative techniques to relieve pain and manage the physical symptoms associated with the dying process reported that the techniques are often or always effective.