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A MedPage Today opinion published Nov. 3, 2026, argues that clinicians beyond geriatrics should help older patients plan for end-of-life care while the United States lacks enough geriatricians. The writer proposes routine, earlier discussions and simpler systems for recording advance directives; the article presents recommendations, not a newly adopted policy or study.
A MedPage Today opinion published Nov. 3 argues that clinicians across health care should take a larger role in helping patients record their end-of-life wishes, as the aging U.S. population faces a shortage of geriatricians. The contributing writer calls for earlier conversations and simpler ways to document advance directives, but the piece describes proposals, not a newly adopted policy or a reported change in practice.
The writer says the United States needs both more primary care doctors and many more geriatricians, but argues that patients cannot wait for the specialist workforce to grow. In the meantime, clinicians who see patients in other settings could help identify preferences and make sure those instructions are available to the care team.
The article focuses on advance-care planning: discussing and documenting what a person would want if serious illness left them unable to make decisions. The writer says these conversations often come too late, when a crisis makes timely decisions necessary or family members disagree about what the patient wanted.
As practical steps, the writer proposes asking about preferences when patients join a new practice, giving people who already have documents an immediate way to upload them, and offering forms and educational materials to those who do not. Examples named include a living will, medical power of attorney and Medical Order for Life-Sustaining Treatment (MOLST). The article also calls for reducing procedural obstacles to hospice and other end-of-life care processes.
Earlier Planning Across Medical Care
The argument is that end-of-life preferences should not depend on whether a patient happens to see a geriatrician or reaches an annual wellness visit before becoming seriously ill. If systems routinely raise the subject and make documents accessible, a patient’s care team and loved ones may have clearer guidance when urgent decisions arise.
The writer also points to the administrative burden on patients and clinicians. Practices already collect information on subjects such as depression, housing and tobacco use, the article says, while advance directives may receive less attention. Making planning a regular part of care could close that gap, though the opinion does not present evidence measuring the effect of its proposed changes.
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How Advance Directives Enter Care
The piece describes current practice from the writer’s perspective: a question about advance directives may appear during a Medicare Annual Wellness Visit, often as a check on whether a patient has a health care proxy or another document. The writer contrasts that approach with asking about preferences earlier and providing a route to add paperwork to a patient’s record.
Advance-care planning can involve several distinct documents and processes, including instructions about treatment and the appointment of someone to make decisions. The writer also references New York State’s Medical Aid in Dying program, but the article does not report a change to that program or provide details about its eligibility rules. Its central point is that systems should make the conversations and paperwork less difficult, not wait for a crisis.
“Geriatricians are masters of this stuff, but until a time where we have thousands more who can help take care of patients during these challenging moments as they approach the end of their lives, we should build up stronger, better, and more respectful systems.”
— MedPage Today contributing writer
No Policy Change Reported
The article is an opinion piece, not a study, government announcement or health-system directive. It does not identify a specific new program, policy adoption, funding commitment or timeline for putting the recommendations into practice. It also provides no workforce figures or projections for the geriatrician shortage.
It is unclear which practices currently collect advance directives at intake, how common the described gaps are, or what effect routine prompts and document uploads would have on care. The article does not specify how proposed processes would handle patients who do not want to discuss these matters, wish to revise their preferences, or need help navigating different forms and state requirements.
Whether Practices Adopt the Proposals
The piece sets out recommendations but names no next implementation milestone. Any changes would depend on health systems and practices deciding whether to add earlier advance-care discussions, document-upload options and patient education to their workflows. The writer’s proposed direction is broader involvement by clinicians while the country works to increase its geriatrician workforce.
Readers should distinguish the call for change from existing requirements: the article does not say that practices have adopted these steps or that patients must complete an advance directive to receive care. Further reporting would be needed to establish how widely such approaches are used and whether they make planning easier in practice.
Key Questions
What is the news development?
A MedPage Today opinion calls for clinicians throughout health care to help patients plan for end-of-life care, arguing that the country has too few geriatricians to meet the needs of an aging population.
Is this a new health care policy?
No. The article presents the writer’s recommendations; it does not report that a government agency, medical organization or health system has adopted them.
What changes does the writer propose?
The writer suggests raising advance-care planning earlier, especially when patients join a practice, and making it easier to upload existing documents or obtain forms and educational materials.
Which documents does the article mention?
Examples include a living will, a medical power of attorney and a Medical Order for Life-Sustaining Treatment (MOLST). The appropriate documents and processes can vary; the article does not give individualized legal or medical advice.
What remains unknown?
The article does not quantify the geriatrician shortage, establish how common the described documentation gaps are, or show whether the proposed steps improve patient care. It also sets no implementation date.
Source: medpagetoday.com
