Physician Management Guidelines for Advance Directives with Patients

There is growing concern regarding the proper implementation of advance directives. A workable model for physicians to use with patients along with appropriate guidelines is discussed in the context of the physician-patient relationship. Examined are variables involved in the establishment of guidelines for use by the physician in the office practice and inpatient settings. Key management and clinical factors for initiating and implementing an advance directive are identified for the practicing physician. Responsibility for the initiation of education regarding the advanced directive is discussed from the patient perspective. Effective use of advance directives with patients requires that a physician have an adequate knowledge base to appropriately guide the patient throughout the treatment process, and that any efforts are coordinated with other healthcare providers.