Ira Byock
speaker
629 appearances
3 recordings
1 series
first heard Jun 2019
last heard Jul 2025
Ira Byock’s voice in public audio — every appearance, attributed to the second.
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So we said fine, you you know, we're you know uh medicine these days is practiced in a team.
You're the chair, you know, as a doctor, you're the head of the team.
But one way or the other, the the system is making a commitment directly to its patients that we're gonna have goals of care conversations.
And, you know, and whoever has that, we're gonna train up all the people who are encouraged to have those conversations, but we're gonna have those conversations.
And and some places it was just the nurses, some places
Uh uh the hospital medicine docs got have gotten involved in a big way and it's it's theirs.
Um I should also say that th in this initiative, we required a goals of care hospital uh goals of care conversation during the hospitalization to meet the performance criteria uh for ICU stays.
But throughout the health system, uh goals of care conversations that were entered in the office by a
A primary care physician counts to other metrics, other quality metrics, because it's just been done.
It's person-centered.
It doesn't have to be done by the oncologist.
It's gonna be done by the primary care doc or the or the hospital medicine doc if the patient's admitted.
goals of care documentation.
So it's a it's both.
Uh in all honesty.
I mean, there is some perfunctoriness to it and some gamesmanship and we knew it going into it back in twenty fourteen and twenty fifteen.
We knew we were gonna get gamed.
I mean, this is not you know the first time I've tried to do this stuff and and none of us
You know, so uh and we saw initially when we when there was a specific uh goals of care note type that you had to open to get it counted, we saw some uh percentage of notes uh that said talk to Joe about uh goals of care, wants to remain full code.
Like speaking.
Showing 61–80 of 629 · page 4 of 32
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