Do physicians engage all the patients in advanced care planning?

There are many obstacles for physicians when it comes to advanced care planning.  We are not necessarily trained in the appropriate way to address this topic and some of us, frankly, feel uncomfortable approaching issues of death with our patients.  It is extremely important to engage patients in this topic, no matter their age or health status, to alleviate tensions and disagreements in the future.  By having a durable power of attorney and advance directive in place, patients are better prepared for end-of-life issues, which will affect every human being at one point or another.  We, as physicians, need to overcome our fear of the subject of advanced care and engage our patients in this critical topic.