Palliative care teaching and today's general practitioners--is it adequate?

Although only 25% of patients die at home, more than 90% of the terminally ill patient's last year of life is at home under the care of their own general practitioner (GP). In the United Kingdom, doctors training for general practice undergo a 3-year training with 2 years in hospital posts and a year in general practice. This questionnaire study of 33 GPs who had recently completed their vocational training was carried out to ascertain the teaching given on palliative care during the general practice component of training. Very few GPs (15%) had received tutorials on palliative care from within their practice. Less than a third felt they had received adequate teaching on pain and symptom control and fewer than 10% perceived the teaching on psychological support to be adequate. Compared to previous studies, the knowledge of specific therapeutics in palliative care had improved, but several were uncertain of basic principles such as the maximum dose of oral opiates which could be prescribed. The majority (85%) wished to have a placement in a hospice as part of their vocational training. This survey suggests that today's GPs would be very receptive to more focused teaching on palliative care encompassing both symptom control and psychological care during their GP training and would also welcome the opportunity of a hospice placement.