This week, the Boston Globe ran a story about how we, as a society, approach the treatment and decision-making around end of life care. This is a topic we are seeing more and more in healthcare as patients are encouraged to become active participants in their care and organizations are striving to meet the triple aim (lowering costs, improving quality and improving patient experience).

The article in the Globe cited studies which found that a small number of patients actually get the end of life care they prefer, many dying in hospitals in the middle of treatment cycles rather than at home. The article questions why that is the case and conjects that perhaps it is because physicians are trained to think about treatments and cures rather than “admitting defeat,” as one physician calls death. End of life care is a complex topic and there is not a one-size-fits-all way to approach it. But we need to think about how to change the culture around end of life care – and this cannot be accomplished without addressing the lack of communication that exists around the issue.

Death is a part of life and a part of healthcare, but too often, physicians and patients never discuss the topic. It’s complicated and uncomfortable and so the conversation just never happens. Programs like The Conversation Project are seeking to change that by changing the culture around death and end of life care. Our client, Atrius Health, has also been a long-time champion of ending the stigma around discussing end of life care and has made significant strides to improve communication between patients and their doctors.

According to the National Center for Health Statistics, although most people say they would prefer to die at home, 56% die in a hospital and 19% die in nursing homes. In order for the culture of healthcare to change, we need to start empowering both patients and physicians to make death part of the conversation.