To the Editor.
—The letter by Ms Mitchell and colleagues1 regarding the cost-effectiveness and quality of hospice care was interesting and further supports the philosophy of interdisciplinary care of dying patients.Unfortunately, there are numerous obstacles to effective hospice care, the most prominent involving physician education and participation. Many physicians fail to understand the tenets of hospice care and erroneously presume hospice programs help patients die. Such assumptions are fallacious and warrant dissemination of information regarding this valuable alternative to technologically expensive and often impersonal care of dying patients. Although select treatments may in fact accelerate death, Simpson interprets hospice in a discerning and factual manner: "Hospice doesn't help people die; hospice helps dying people."2Patients often desire hospice care when informed of the philosophy and interdisciplinary nature of care. Most patients want to die at home, and hospice affords such an opportunity in a team-oriented environment that
Rousseau P. Hospice Care. JAMA. 1994;272(10):767. doi:10.1001/jama.1994.03520100031019