Response: Re: A Reflective Case Study in Family Medicine Advance Care Planning Conversations

To the Editor: We appreciate Dr. de Caprariis' thoughtful comments on our article. Indeed, we agree with nearly all them!

We do have 2 comments in return:

First, we suspect many practicing family physicians will find the suggestion of discussing Advance Care Planning (ACP) with all adults somewhat overwhelming. While we strongly encourage our colleagues to do that, we believe that targeting people over 65 years of age and patients of any age with serious acute or chronic illness is an alternative, pragmatic approach.

Second, although we absolutely support including ACP conversations as part of routine health care maintenance, we wonder about linking them to “annual physical” appointments. Many family physicians integrate preventive care longitudinally; the challenge, it seems to us, is to make the time to discuss document ACP sometime. Following up with undecided patients is also critical.

What is most important is that we family physicians integrate ACP with our patients, exploring what works best in context of our own practices.