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A MedPage Today opinion published Nov. 3 argues that health practices should involve patients in advance-care planning earlier and make it easier to record their preferences. The writer says broader clinician participation could help address gaps while the country lacks enough geriatricians; the piece is an argument, not a report of a new policy or study.
A MedPage Today opinion published Nov. 3 argues that health practices should make it easier for patients to document their end-of-life wishes before a serious illness leaves little time for discussion. The contributing writer says all clinicians can help fill the gap while the United States lacks enough geriatricians to meet the needs of an aging population.
The writer proposes asking patients about advance directives when they begin care with a new provider, rather than relying mainly on questions during a Medicare Annual Wellness Visit. Patients who already have documents could be invited to upload them to their medical record; those who do not could receive forms and educational materials. The piece names living wills, medical powers of attorney and Medical Orders for Life-Sustaining Treatment, or MOLST, as examples.
The article’s central recommendation is to make these discussions a routine part of care, while allowing patients to change their preferences as circumstances evolve. The writer also argues that healthcare systems should reduce administrative hurdles that can complicate MOLST paperwork, hospice enrollment and access to New York State’s Medical Aid in Dying program.
These are proposals in an opinion article, not announced requirements or reported changes to clinical practice. The piece does not present new data on the number of geriatricians, quantify the effect of advance-care planning, or describe a specific health system adopting the suggested approach.
Planning Before a Crisis
Advance-care documents can help patients communicate preferences and give clinicians and family members information to consult if a patient later cannot speak for themselves. The writer argues that raising the subject earlier could reduce uncertainty during urgent decisions and make it easier for care teams to respect a patient’s choices.
The proposal also points to a practical limit: clinicians need time and systems to discuss, record and revisit preferences. Asking every practice to help could spread some of this work beyond geriatricians, but it would not replace specialist care or resolve the workforce shortage. The opinion does not establish how much the proposed steps would improve outcomes.
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Primary Care and Aging Patients
The opinion frames its argument around two linked concerns: an aging population and what the writer describes as an inadequate supply of geriatricians. It says other specialties can attract more physicians, while the number entering geriatrics has not grown dramatically. The article offers no workforce counts or comparison data, so that assessment remains the writer’s characterization rather than a quantified finding in the source.
The writer contrasts the many screening forms patients may encounter at medical practices with the less frequent opportunity to record advance-care preferences. In the article’s account, questions about advance directives may appear during a Medicare Annual Wellness Visit, but patients are not always offered a straightforward way to provide documents or get help completing them. The proposed response is to build that opportunity into routine care earlier, not to wait for a terminal diagnosis or emergency.
“Geriatricians are masters of this stuff, but until a time where we have thousands more who can help take care of patients during these challenging moments as they approach the end of their lives, we should build up stronger, better, and more respectful systems.”
— The MedPage Today contributing writer
Adoption and Impact Remain Open
The article does not identify a health system that has adopted the proposed intake process, nor does it report a policy change, clinical trial or measured result. It is unclear how frequently patients currently complete advance directives, how many practices would have capacity to offer the proposed assistance, or which administrative requirements could be removed without affecting legal safeguards.
The writer does not specify a single standard workflow for patients whose preferences change, or explain how practices should handle differences among state forms and rules. The article’s discussion of New York’s Medical Aid in Dying program is part of its argument about administrative complexity; it does not report a new development in that program.
No Implementation Date Given
The opinion does not announce a next milestone or say that a regulator, medical organization or provider network will act on its proposals. The next step, if practices or health systems choose to pursue the approach, would be to decide how to ask patients about their wishes, store relevant documents securely and revisit them when circumstances change.
Readers should distinguish that possible work from confirmed developments: the source is a commentary advocating earlier conversations and simpler processes, not evidence that a new requirement is in force. Any adoption, guidance or measured impact would need to be reported separately.
Key Questions
What is the MedPage Today article calling for?
It argues for discussing advance-care preferences earlier and giving patients a routine way to submit or complete documents through their healthcare practice.
Is this a new healthcare policy?
No. The source is an opinion article proposing changes; it does not announce a rule, mandate or system-wide program.
Which documents does the article mention?
Examples include a living will, a medical power of attorney and a Medical Order for Life-Sustaining Treatment, or MOLST. Requirements and forms can vary by location.
Why does the writer want conversations to happen sooner?
The writer argues that a serious illness can make timely decisions difficult and that earlier discussions may help patients communicate their preferences before a crisis.
Does the article say the proposal has been tested?
No. It reports no study or outcome data measuring whether the suggested workflow improves care or reduces the burden on patients and clinicians.
Source: medpagetoday.com
