What They’re Watching: Hilton Raethel

Hilton Raethel, President and CEO of the Healthcare Association of Hawaii, joins us in this edition of “What They’re Watching” to talk about healthcare conventionalities surrounding end of life care.

One of the trends that we’re focusing on is around end of life care. Now, the United States is an amazing county, it has amazing health care. And we have this can do attitude which means that in health care, as in many other parts of life, if you can do something, you should do something. Now when it comes to end of life care, that is not necessarily the case. Just because you can do something, just because you can perform a surgery, just because you can perform an intervention, the question is, “Is that really what is the best for that patient, that family at that point in time?”

One of the other trends, good trends that is happening is we’re starting to increase the awareness of what should happen at the end of life. We are increasing the use of palliative care, the use of hospice care, we’re reducing unwanted care and unnecessary care. And it’s terrible that when you talk about unwanted care that some people are getting care that they wouldn’t want if they really understood what they were getting. It doesn’t prolong life, it may be increasing suffering, and part of it is this attitude that if we can do something we should do it. So the good news is that more and more people are talking about it, the patients and the families are getting involved in the care, they’re asking questions of the caregivers, the physicians, the nurses. “What will this intervention do? Will it actually improve the quality of my life when I’m at the end of my life?”

And so there’s some great conversations that are going on right now but we need to have more of those conversations. We need to have more people filling out their POLST, their Physician Orders for Life-Sustaining Treatment. People should have choices and they should not have things done to them that they would not want. When you talk about doctors, for example it’s really interesting, they are much more conservative about what they want for themselves than what many of them prescribe for their own patients and we need to change that dynamic.