The widely-accepted idea that doctors are more likely to choose to die at home or with fewer interventions than other people at the end of their lives has been dispelled.
A Canadian study, comparing end-of-life pathways between 2,507 physicians and 7,513 non-physicians in Ontario between 2004 and 2015, found the groups were more alike than not.
The primary outcome of rates of death at home was similar in both groups (42.8% v 39.0%).
Physicians and non-physician groups also had similar rates of interventions in the last six months of life including mechanical ventilation, dialysis and CPR.
The rate of recent Emergency Department (ED) visits was was lower for physicians compared to non-physicians (73.0% v 78.4%) but the risk of hospital admission was similar (67.0% v 70.6%).
Slightly more deaths in ICU occurred amongst physicians than non-physicians (11.9% v 10.0%).
Doctors were also more likely to access palliative care (52.9% v 47.4%) and at-home care visits (54.3% v 50.1%) than other people.
In a subgroup of people with chronic illness, patterns of care were similar between physicians and non-physicians, although physicians were more likely to die at home (35.2% v 30.7%).
Similarly, in a subgroup of people with cancer, physicians were more likely to die at home than non-physicians (37.6% v 28.6%) but they also received more chemotherapy (37.9% v 29.8%).
Total costs of care in the last six months of life were similar between the two groups.
The researchers said in JAMA Network Open that the differences in patterns of care between the two groups were small and inconsistent and suggested “greater complexity in end-of-life decision-making than a dichotomous model of less vs more”.