Backline and Dr G Share How to Scale Advance Care Planning in a Medical Practice

Andy Gulbis, MD, Owner at Dr. G Medical Solutions, says that one of people’s top concerns is for the last week of their life “to be on my terms.” In this extended video conversation, Gulbis and Rishi Sarna, MD, Chief Clinical Officer at Backline, discuss the purpose and process of advance care planning (ACP).

Advance care planning is one of the major focuses of Backline’s planning and scheduling platform, which allows patients to answer the critical questions of ACP and prepare for a dialog with a clinician. Along with ACP, Backline can also help with other areas of workflow (or critical pathway) planning such diabetes, asthma, and congestive heart failure.

Dr. G Medical Solutions is a small rural health care clinic in Texas that has been running for three years and that Gulbis calls a “one-stop shop” for medical care. They use Backline to help start a conversation and take from the clinician both the time burden and the emotional burden of starting these difficult conversations.

A big issue with ACP is simply getting a conversation going. Gulbis explains how patients come in to discuss how to get better, so it’s hard to switch the conversation to inevitable end-of-life considerations. It’s an achievement just to get patients in for annual checkups and to discuss chronic conditions. They don’t want to go into the doctor for an even longer visit to address the ACP.

Sarna points out that ACP is not usually part of medical training, and that residents should be introduced to it so they have time to grow into being comfortable with it. He says the ACP discussion should be part of standard of care, just like immunizations, blood work, and cancer scans.

Every hospital should make sure that incoming patients have an ACP, which could be much more than an advance directive. If a long-term care facility or PCP has the ACP but no copy is available to the hospital, they can’t consider it when making critical decisions such as whether to resuscitate an unconscious patient. One of Backline’s advantages is to make the ACP available to everyone who needs it and it can be done virtually at the patient’s convenience. A document detailing the ACP is valuable when a family is bickering over what to do with a dying patient.

Sarna would like every adult to go through ACP. It’s valuable when they have to enter a hospital. The basic question is how much effort to put into lengthening life.

Gulbis says having the conversation before a person is ill can contribute to a feeling of peace when the end comes.

See the video for a deep discussion of how to make ACP part of medical practice without burdening your clinical providers.

Learn more about Dr. G Medical Solutions: https://drgmedicalsolutions.com/

Learn more about Backline from DrFirst: https://backlinehealth.com/

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