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Doctors are less likely to die in hospital, have surgery or be admitted to intensive care, than the general public, new research has revealed.

While most people report a wish to die at home rather than in a medical facility, the majority of deaths do occur in a hospital or nursing home setting.

However, two recent studies suggest doctors are more likely to die in a manner more consistent with end-of-life wishes, than the general population.

Experts suggest one of the reasons doctors may receive less intensive end-of-life care is because they are all too aware of the burden it places on both the patient and their loved ones.

 

 

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Doctors are less likely to die in a hospital than members of the general public, two recent studies have suggested. One reason to explain the trend is that doctors are very aware of the burden intensive end-of-life care can place on the patient and their loved ones

Another reason, they put forward, is that doctors know better than most the benefits of palliative care in the home - and are able to afford to pay for the often expensive nursing.

The first study, carried led by Dr Joel Weissman at Brigham and Women's Hospital in Boston, examined whether doctors receive higher or lower intensity end-of-life treatments compared with non-physicians.

They examined the medical records of people aged 66 or older who died between 2004 and 2011 in Massachusetts, Michigan, Utah and Vermont.

Researchers concluded doctors were less likely to die in a hospital compared with the general population - 28 per cent versus 32 per cent.

They were also less likely to have surgery - 25 per cent versus 27 per cent - and were less likely to be admitted to intensive care - 26 per cent versus 28 per cent.

The authors wrote: 'The possible reasons physicians received less intense end-of-life care than others could be knowledge of its burdens and futility, as well as the benefits and the financial resources to pay for other treatment options, such as palliative care or skilled nursing required for death at home.' 

The second study, led by Dr Saul Blecker, of the New York University School of Medicine, compared the location of death of doctors with that of other healthcare professionals, and the general public.    

Researchers analyzed data from the National Longitudinal Mortality Study, including individuals aged 30 to 98 years old who died between 1979 and 2011.

They placed each person into one of four categories relating to profession - physician, other health professional (dentist, nurse, pharmacist, for example), other high education and all others.

Those deemed to be in other higher education roles included people not employed in health care who completed six or more years of post-secondary education.

Next, they looked at two outcomes - death in an inpatient hospital, and more broadly death at a medical facility, including clinics, nursing homes, and physician's office for example. 

Of the 471,243 people in the study, 815 were doctors, 2,635 were other health professionals.

Meanwhile 15,308 were categorized as other higher education and the remaining 452,485 were all others.

 

 

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Another reason for the trend, experts say, is that doctors recognize the benefits of palliative nursing at home, and can afford the often expensive care

Of deaths, 40.3 per cent happened in an inpatient hospital, and 72.1 per cent occurred in any facility.

Researchers found those in the 'all others' category were 'more likely than physicians to die in a hospital'.

The authors of the study, published in the Journal of the American Medical Association (JAMA) noted: 'Our results suggest that familiarity with health care and educational attainment may have a small association with experience of death.'

Addressing the issue, Dr Jacquelyn Corley, writing for CNN, said: 'There comes a time for every person when his or her identity is gone, and the quality of life should be valued more than the mere presence of it.'

That, she said is a view shared by many healthcare professionals.

But, it is an idea that can conflict with the public's general consensus.

Dr Corley added: 'It is a painful truth that doctors are often asked to continue the kind of intensive measures they would never wish for themselves or a loved one.'

She said medical professionals 'know how precious life is'.

'We understand how difficult it is to watch family members lose people they love.

'But we also know in modern medicine, dying with dignity is a luxury more people should enjoy.'

Both studies were published in JAMA