Special challenges face doctors who care for a dying colleague

Just like other patients, dying physicians can delude themselves when the end is near.

By Andis Robeznieks, AMNews staff. Nov. 24, 2003.

In the process of providing end-of-life care for a colleague, doctors can learn to better understand the dying process, develop greater empathy for patients and their families and come to realize how they would want to be cared for, conclude Erick Fromme, MD, and J. Andrew Billings, MD, in the Oct. 15 issue of the Journal of the American Medical Association.

Drs. Fromme and Billings recount the story of "Dr. B," a former chair of a hospital department of medicine, who died at 70 after years of treatment for heart disease and a blood disorder. In telling his story, they explore strategies for handling the unique aspects of caring for physicians at the end of life such as self-doctoring, perfectionism, confidentiality, and professional identity and empathy.

While treating a dying doctor, the authors say colleagues can go overboard in providing so much attention their other patients are neglected. Or, they can also go the other route and, "out of kindness," provide substandard care by sugar-coating bad news, failing to ask about personal issues or skipping important but sometimes uncomfortable procedures.

"I think probably the most important thing when taking care of a physician patient is that you have to figure out a way to realize the specialness of the patient without letting it interfere with the standard of care that every patient deserves," said Dr. Fromme, a palliative care physician in the division of general medicine and geriatrics at Oregon Health and Science University in Portland.