Hospice care is a specialized form of medical support focused on comfort and enhancing the quality of life for an individual nearing the end of life. Electing hospice signifies a shift in focus, meaning treatment to cure the underlying terminal illness is no longer pursued. Although the structure of medical care changes significantly upon enrollment, the patient continues to receive comprehensive, doctor-supervised attention tailored to their needs.
The Medical Team Overseeing Hospice Care
The primary medical oversight for a patient in hospice is provided by the Interdisciplinary Team (IDT). This multidisciplinary group includes professionals who manage all aspects of the patient’s physical, emotional, and social well-being. The team’s efforts are certified and overseen by the Hospice Medical Director or a designated Hospice Physician.
The Hospice Medical Director is a doctor responsible for the overall medical care plan and certifies the patient’s eligibility for services. This physician is an expert in pain and symptom management, though they may not be the doctor the patient saw previously. The IDT also includes a Registered Nurse (RN) case manager, who often becomes the most consistent medical contact for the patient and family.
The RN case manager conducts regular visits, monitors the patient’s condition, and acts as the liaison between the patient and the hospice doctor. Other IDT members include certified home health aides, social workers, spiritual counselors, and volunteers. This team structure ensures that medical needs are addressed promptly and on-site, typically in the patient’s home or current residence.
When You Can See Outside Physicians
A common concern when enrolling in hospice is whether the patient can still see their established Primary Care Physician (PCP) or other specialists. The answer is yes, but the context of the visit is strictly regulated by the hospice benefit structure. The patient has the right to choose an attending physician, who can be their regular PCP or specialist, to work alongside the hospice team.
The distinction is between care for the terminal illness and care for conditions entirely unrelated to that illness. All medical services, equipment, and medications intended to manage the terminal diagnosis must be provided by or coordinated through the hospice provider. This rule ensures the comfort-focused plan of care is not disrupted by conflicting treatments.
A patient can continue to see outside doctors for unrelated health issues that require specialized or routine management. For example, if a patient is in hospice for congestive heart failure but needs to see a dermatologist or an orthopedist for a broken wrist, these visits are permissible. The hospice team must be informed of any outside appointments to ensure proper coordination of care and prevent confusion regarding payment coverage.
Distinguishing Palliative Care from Curative Treatment
The ability to see outside physicians is tied to the difference between palliative care and curative treatment, which is codified in the financial framework of hospice. Hospice care is a defined benefit, often through Medicare, covering all services for the terminal illness under a plan focused solely on palliation, or comfort. Palliative treatment aims to relieve symptoms and reduce suffering without attempting to reverse the disease.
Curative treatment is any medical intervention intended to cure the disease, slow its progression, or prolong life. Once a patient elects the hospice benefit, they agree to forgo all curative treatments for the terminal illness. The hospice benefit will not pay for any services, tests, or medications considered curative for the qualifying diagnosis.
If a patient decides they want to pursue treatment to cure or slow the terminal illness, they must formally revoke their hospice election. This process, known as revocation, immediately ends the hospice benefit, and the patient returns to standard medical coverage. A patient can later re-elect hospice if their condition meets the eligibility criteria again.