By Susan Nelson, MD, LaPOST Coalition Chair (@geripaldoc)

A new year is a time for new beginnings, and from a health care perspective, 2016 marks the dawning of a new era for advance care planning in America. As of Jan. 1, Medicare will reimburse physicians who discuss advance care planning options with their patients. This new provision signals a shift toward broader acceptance of discussing the kind of medical treatments you would want if you couldn’t speak for yourself with your health care team and family. This helps all know in advance your treatment wishes and goals of care.

Many health care advocates would agree that this policy change is long overdue, having been shelved since 2009 after a well-known career politician’s successful fear mongering likened the funding of such services to the creation of government-sponsored “death panels.”

Since then, more Americans have come to understand that advance care planning is designed to improve the quality of life for patients with serious illnesses by enabling them to select the care options they prefer. This sentiment is reflected in the mounting public support for doctor-patient conversations of this nature. A recent poll by the Kaiser Family Foundation found that 81 percent of those surveyed favored Medicare coverage for end-of-life care discussions.

Because of the new policy, more than 49 million Medicare beneficiaries could potentially join in these conversations this year.

As a geriatrics and palliative care physician, I have witnessed during moments of crisis how having a care plan can alleviate stress for a patient’s family, allowing them to focus on supporting their loved one, instead of bearing the burden of deciding a course of treatment. The peace of mind that an advance care plan can provide during this difficult time is invaluable. However, despite its benefits, discussing end-of-life treatment options isn’t a conversation most people are ready and willing to have.

Often, patients and families delay having these discussions because it’s uncomfortable to think about or because they prefer to wait until the “right time.” But truthfully, there is no time like the present when it comes to documenting your health care wishes.

In Louisiana, residents have multiple advance care planning options to consider. In addition to the advance directive, or living will, and the health care power of attorney, patients seeking to express their medical preferences and goals of care may complete a Louisiana Physician Orders for Scope of Treatment (LaPOST) document. The LaPOST document is designed specifically for those with serious, advanced illnesses and allows patients to choose the medical treatments they would or would not want to receive as their illness progresses.

LaPOST is completely voluntary, can be revised or revoked at any time and transfers with patients across care settings. Because it is a physician’s order, doctors must take a leading role in guiding their patients through each section of the LaPOST document, ensuring they have enough information to make the best decisions for their health and wellbeing.

A physician’s role in a patient’s life is far greater than making diagnoses and writing prescriptions. We have a responsibility to provide patients with the best medical care we can, while maintaining their trust and offering guidance as needed. Through the Medicare policy change, our roles have expanded even further and it is imperative that we rise to the challenge by normalizing advance care planning discussions to help remove the stigma that has long surrounded end-of-life care. Let’s renew our commitment in 2016 to improving the lives of our patients, one conversation at a time.

For more information about LaPOST, visit