Dying Feel Abandoned by Docs in the End(been trained in dealing with end-of-life...),Health

But, he said, "even though the medical care system doesn't reward doctors for this type of care, many times when doctors do make these kinds of contacts, they find them very rewarding."

"Even just a phone call or two to check in is tremendously important to the family to let them know you're still paying attention," said Back.

"This is an area that the health-care profession is becoming much more mindful of," said Dr. Sean O'Mahony, medical director of palliative care at Montefiore Medical Center in New York City. "This study emphasizes that patients and caregivers attach value to how we communicate and how we end professional relationships with patients when that patient needs to transition to another care center."

Two other studies in the same issue of the journal focused on the costs of end-of-life care. The first, from researchers at Dana-Farber Cancer Institute in Boston, found that when people with advanced cancer and their physicians talk about end-of-life care and what the patient wants, that end-of-life care averages about $1,000 less per person and that the quality of death was higher for those who had a chance to tell their physicians what they wanted.

The second study, from Boston University researchers, looked at cost differences in end-of-life care for different racial groups, and found that in the last six months of life, health-care costs for whites averaged $20,166, for blacks it was $26,704, and for Hispanics, $31,702. The biggest reason for this disparity was the use of more life-sustaining interventions in blacks and Hispanics.

Finally, a survey of people in Oregon who requested physician aid in dying found that their major interest in requesting assistance in dying stemmed from concern about physical discomfort, a poor quality of life and loss of autonomy.

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