Digitize your own advanced-care plan

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The holidays are here, and with them time to gather with family and friends. This year, as we gather around the holiday table, I suspect that healthcare will be a common theme.

I challenge you, though, to move beyond the politics to discuss a topic that really matters: you, your voice, your thoughts. Who do you want empowered to speak for you during a medical crisis if you can’t? What kind of medical care would you want, or want to avoid? What are your hopes and fears if you were in an emergency situation?

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While some of us might have thought about if we would want life-saving measures used, such as CPR or a ventilator, not nearly enough of us have shared those preferences with our loved ones, and even fewer have documented them in an advance medical directive.

Now, here’s the kicker. For the very few who have created a directive, can we — or better yet, our future doctors — access it immediately if needed?

While you might feel powerless to affect health reform, you can take charge of your own care by using this holiday season to discuss your thoughts and digitize them so your preferences are known. Make your voice heard. Don’t wait for an accident or illness to strike — there’s too much else to focus on, and your decisions need to be clear.

As a transplant surgeon, I saw critical health situations every day. I know firsthand the emotions that accompany the time spent in emergency rooms and intensive care wings. I’ve walked that road with hundreds of patients and their families. 

Consider that at the end of life, nearly all patients will lose the ability to make their treatment preferences known — some in their last days, others for weeks or months on end. In the absence of advance care planning, patients are much more likely to receive medical interventions that can actually prolong or worsen their suffering and will certainly increase expense for their loved ones.

For example, cancer patients without advance care planning are seven times more likely to be placed on mechanical ventilation, and eight times more likely to have emergency CPR prior to death. On the other hand, nursing home patients who engage in such planning are less frequently hospitalized, report improved patient and family satisfaction, and experience 33 percent lower costs of care.

I imagine some of you are thinking, “Yes, this makes sense for my parents or grandparents.” I can assure you this is not a topic just for the elderly or sick; this is a topic for all of us. Talk of “death panels” during the healthcare debate was a distraction — and a dangerous one, at that. The truth is that we all need to take personal responsibility for our own end-of-life wishes.

If you won’t create your directive for yourself, do it to relieve a burden on your loved ones. I’ve talked with patients and families across the country about their end-of-life experiences. Families report that facing a decision about a loved one’s treatment near the end of life is one of the most stressful life events. However, for families whose loved ones have prepared a treatment plan, the experience is more peaceful. These families are able to take advantage of precious time together, rather than worry about and debate the right course of action.

There’s no better time than during the holidays to start the conversation with your loved ones. MyDirectives.com, for instance, offers free digital advance medical directive forms online with instructions on completion and how to introduce the subject with family. The service helps ensure doctors can find your directive online during a crisis.

When a good advance directive is in place, providers can better do their jobs, and patients can be confident that their wishes will be part of the treatment process. Your doctors are medical experts, but only you are the expert on your hopes and preferences. An advance care plan relieves your family and physicians of the burden of having to guess your wishes.

These days, we’re hearing many voices in support of — or in opposition to — various parts of the healthcare law. But when it comes to one of the most important healthcare decisions you will ever make, the voice we really need to hear is yours.

Frist represented Tennessee in the U.S. Senate from 1995-2007 and was Senate majority leader from 2003-2007. He is a heart and lung transplant surgeon.