Most Oncologists Don’t Refer to Palliative Care. What???

I was shocked when I learned this fact

I have lost count of the number of times I have had patients with advanced cancer who get critically ill with any number of illnesses: infections, blood clots, collapse of lungs, among others. And more often than not, it falls to me, as the critical care medicine doctor, to speak the patient and/or family about goals of care.

Do not get me wrong, I love having these conversations. If I can ascertain my patients’ goals of care, especially at the end of their lives, and mitigate their suffering, it brings me no shortage of happiness.

At the same time, if I am the first physician to have a goals of care conversation, it is really too late. These conversations need to have been done way, way, way before they reach me in the ICU. Unfortunately, however, this does not happen, and the conversation falls to me.

One would think that an Oncologist would know better. Yet, I was shocked — truly shocked — to learn that most Oncologists who have patients with advanced cancer do not refer their patients to Palliative Care. I learned this from a wonderful Substack called PulmCCM.

Their post, “Why don’t oncologists refer to palliative care?” discussed how the American Society of Clinical Oncology, it…