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A Nov. 3 MedPage Today opinion argues that primary-care teams should help patients discuss and record end-of-life care preferences before a crisis. The writer says the shortage of geriatricians makes stronger practice systems more important, but the piece does not announce a new policy or provide workforce figures.
A MedPage Today opinion published Nov. 3 argues that primary-care practices should make it easier for patients to record their preferences for serious illness and end-of-life care, as the United States faces an insufficient supply of geriatricians. The writer proposes routinely asking about advance directives, helping patients complete or upload documents, and reducing administrative obstacles; the article is a call for change, not an announcement of a new program.
The contributing writer says many older patients will live with good health, while others will face chronic illness, frailty or terminal diagnoses. In the writer’s view, clinicians need to be ready to support patients both in the years before the end of life and when decisions become urgent. The opinion says the country needs more primary-care doctors as well as many more geriatricians, but does not provide workforce counts or cite a specific estimate of the shortage.
The proposed response is to make advance-care planning easier to begin before a medical crisis. The writer suggests that practices ask new patients about their preferences and existing documents, give patients a straightforward way to upload completed directives, and offer forms and educational materials when they do not have them. Examples named in the article include a living will, a medical power of attorney and a Medical Order for Life-Sustaining Treatment, or MOLST.
The writer also argues that electronic systems could help prompt conversations across routine visits, rather than leaving questions about directives until a Medicare Annual Wellness Visit. The article says patients may change their minds as circumstances change, so any process should allow records to be updated. Its recommendations reflect the author’s opinion; the piece does not report a study, describe a health system that has implemented the proposal, or establish its effects.
Planning Before a Medical Crisis
Advance-care plans can give clinicians and loved ones a record of what a patient says they would want if illness leaves them unable to speak for themselves. The writer warns that when those conversations are delayed, relatives may disagree about the patient’s wishes and decisions can become more difficult under time pressure. That is the problem the proposed routine prompts and document support are intended to address.
The argument also reaches beyond specialist care. If geriatricians are not available to advise every older patient, the writer says other clinicians and practice systems can help identify preferences and make them accessible. The article’s focus is on a practical gap between asking about a directive and helping the patient complete, share or revise one. It does not claim that paperwork alone can resolve disagreements or substitute for a conversation between patients and care teams.
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From Wellness Visits to Routine Care
The opinion describes a typical outpatient workflow in which patients answer multiple screening questions, but are asked about advance directives mainly during a Medicare Annual Wellness Visit. It says the templated questions may establish whether a patient has a health-care proxy or another directive without necessarily helping them create or upload one. This description is the writer’s account of practice, not a survey of clinics nationally.
The article compares advance-care planning prompts with familiar administrative requests, such as showing an insurance card at visits or being asked about organ donation when renewing a driver’s license. The writer’s proposal is to treat patients’ care preferences as information practices should actively help collect and keep current. It also calls for fewer procedural barriers to processes such as MOLST completion and hospice enrollment, while offering no detailed policy plan or legal analysis.
“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
Scope and Results Remain Unspecified
The article does not quantify the geriatrician shortage, cite data on how often patients lack advance directives, or measure how often existing documents are unavailable to clinicians. It also does not provide evidence that routine prompts or easier document handling would improve care, reduce family disputes or make end-of-life processes faster.
Several proposals remain broad. The writer does not specify which organization would set a standard, how practices would fund staff time, how systems would handle privacy and document updates, or how differing state rules would affect forms and procedures. The piece is an opinion article, so its account of current practice and its recommended changes should not be treated as a new national policy or a finding from original research.
No Policy Change Announced
The opinion does not announce a government, hospital or professional-body response, nor does it set a timetable for adopting its suggestions. The next step described by the writer is for health practices to make advance-care conversations easier to start, offer patients relevant forms and educational materials, and create a way to store and update completed documents.
Whether clinics or health systems adopt those measures, and whether they change patient access to geriatric or end-of-life care, is not established in the article. Readers should expect any implementation to depend on local clinical workflows and applicable rules; the report provides no confirmed rollout to follow.
Key Questions
What development does the article report?
It reports an opinion published by MedPage Today on Nov. 3, 2026, calling for primary-care practices to make advance-care planning more routine and less administratively difficult. It does not report a newly adopted policy.
What does the writer want health practices to do?
The writer proposes asking patients about care preferences earlier, helping them upload existing directives, and providing forms and educational materials when they do not have documents. The article also suggests that practice systems prompt these discussions across routine care.
Which documents does the opinion mention?
Examples include a living will, a medical power of attorney and a Medical Order for Life-Sustaining Treatment, or MOLST. The article does not give state-specific legal instructions for completing them.
Has a new program or rule been announced?
No. The source is an opinion article, and it does not announce a government rule, health-system rollout or professional standard. Whether its suggestions will be adopted is unclear.
Source: medpagetoday.com
