Dear Fellow Physician:

Allow me to thank you for the countless hours and effort you put into caring for your patients. I am reminded daily by your patients of what a wonderful job you are doing. My hope is that when your patient reaches the end of life, we at Harry Hynes Memorial Hospice will be able to help you in caring for your patient and their family. Please look on us as the best tool you have to assist you in caring for your patients at the end of life.

How do you decide whom to refer? Some thoughts ...

• Ask yourself "Would I be surprised if this patient dies?"  If the answer is 'No', consider a Harry Hynes Memorial Hospice referral.
• Ask yourself "In my best judgment, do I expect this patient to live more than 6 months?" Again, if the answer is 'No', consider a Harry Hynes Memorial Hospice referral. (The latest Medicare guidelines state that the determination is to be "based on the physician's or medical director's clinical judgment regarding the normal course of the individual's illness.")
• Harry Hynes Memorial Hospice is caring for more and more patients with non-cancer diagnoses such as CHF, COPD, Dementia, and other progressive, end-stage diseases. Admission guidelines have been established for each of these. Please contact us if you'd like details, or refer to  http://aspe.hhs.gov/daltcp/reports/impquesa.htm#appendixC.  If in doubt, contact me (Dr. Gerard S. Brungardt) or consult Harry Hynes Memorial Hospice (316-219-1721) for a referral.

Remember that I will be glad to help in the evaluation of your patient at the referral or after they are admitted. I am happy to assist in consultations for pain and symptom management, evaluation of hospice appropriateness, or areas of decision-making and ethics. This can be done in the hospital or at the patient's home, before or after admission to Harry Hynes Memorial Hospice

How do you talk with the patient and family about all this?

• An approach many physicians have found valuable is something along the lines of "Hospice is the best tool I have to provide the care you need at this stage of your illness."
• There are many resources available for physicians to assist them in how best to "Break Bad News". Please refer to http://www.epec.net/EPEC/Media/ph/module2.pdf.

Most of the time, the patient and family are relieved that someone has finally acknowledged the seriousness of their condition.

As the hassle-factors in so many areas of medicine seem to multiply daily, please consider Harry Hynes Memorial Hospice one place where you can decrease many of the day-to-day hassles and allow yourself to focus on what you do best - provide outstanding medical care to your patients and their families.

Best Regards,
Gerard S. Brungardt, MD, FACP
Email Dr. Brungardt
(316) 219-1758 (Office)

For additional information regarding palliative and supportive care, hospice, or bioethics, please visit Dr. Brungardt's website at http://www.brungardtmd.com/about/.