Hospice Patients Alliance: Consumer Advocacy

Hospice Medical Director And Attending Physician:
At Your Service

Each hospice has a Medical Director who is a physician. The Medical Director has an obligation to make sure that each hospice patient receives all the medically indicated services needed to control the symptoms of the patient's terminal illness. According to the Federal regulations (42 CFR 418.54), the Medical Director "assumes overall responsibility for the medical component of the hospice's patient care program." Quite often, the Medical Director has much experience in treating the symptoms of the terminally ill, and, therefore, can be a valuable resource to the patient, the family and hospice staff in managing the symptoms that arise from time to time.

Although each patient has his own Attending Physician, the patient's also have access to the Medical Director of the hospice if there is any problem in obtaining control of the symptoms. Your loved one's attending physician works with the RN case manager and other hospice professionals to manage the symptoms of the terminally ill in hospice care. Any procedures, medications or other treatments must be approved by the attending physician. The hospice uses standing orders which the attending physician approves before cases are accepted at the hospice.

The Medical Director serves as a secondary check on the Attending Physician to make sure that the patient receives the very best of care. In some instances, an Attending Physician may not order the medications needed for the patient's comfort or to control the symptoms adequately. The RN casemanager will communicate the patient's needs to the Attending Physician. If the Attending Physician refuses to provide for the patient's needs, the Medical Director should be consulted to intervene on the patient's behalf.

Part of the benefit of utilizing hospice services is the extra assurance that the patient will be kept as comfortable as possible, and the hospice Medical Director and attending physician are an important part of the Interdisciplinary Team that makes the plan of care for each patient. If your loved one is not getting what he or she needs for management of symptoms and pain control, insist on speaking with the attending physician and the hospice Medical Director directly. It is your right.

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