[Palliative care: profile of medical practice in the Quebec city region]

Abstract

OBJECTIVE: To describe the palliative care provided by physicians in the Quebec city region and to identify factors that affect its delivery. DESIGN: Mailed survey. SETTING: Quebec city region. PARTICIPANTS: General practitioners in active clinical practice. MAIN OUTCOME MEASURES: Physicians' personal and professional characteristics and their palliative care practice (volume of work, source of requests for follow-up care, place of delivery of care, resources used, difficulties, encountered). RESULTS: Of the 476 physicians (67%) who responded to our survey, 295 (62%) provided palliative care. Of these, 70% saw no more than two patients requiring palliative care per month, and 55% devoted no more than 2 hours per week to this aspect of patient care. Most (76%) provided palliative care in a variety of settings (private office, home, institution). Home care teams working out of local community health centres are the resource physicians drew upon most frequently (69%). The main difficulties encountered were a lack of clinical expertise, scheduling home care, and providing patients and families with emotional support. CONCLUSION: Most physicians in the Quebec city region provided palliative care occasionally. This care could be improved by removing various logistical and professional barriers.