October is Sudden #Cardiac #Arrest Awareness month. Today the current system to document your wishes fails. When you have seconds to minutes to have your life saved, would you want someone to guess with your care? Learn more mideohealth.com

320,000 people between the ages of 20 and 64 die unexpectedly in this country every year. 60 percent of adults have no advance directive. We counsel patients on smoking and exercise and tend not to raise this at all. That argument comes from Joseph Pepe, a retired internist who moved into administration, ran a 330-bed hospital as its CEO, sat on hospital boards and on the board of an insurance company, was a patient with a life-threatening illness twice, and then became the caretaker for a wife whose illness was called terminal. His position is that the estate planning packet belongs in the same category as the exercise talk and the smoking talk. He is explicit that we tend not to do it because a visit already has too much in it, and equally explicit that this is not a reason. Sometimes it takes more than one visit, and he says that is fine. The vocabulary is where most of us go fuzzy, so here it is cleanly. An advance directive, or living will, records what the patient would want. It is wishes, not orders. A POLST or a DNR is an order. Different instrument. And it does not travel the same way across state lines, so a form that governs in one state may not govern in another. A health care proxy, or medical power of attorney, names who speaks when the patient cannot. A durable power of attorney covers money. It is a separate document from the medical one, and people conflate the two constantly. A HIPAA release is the one everybody forgets. Without it, the family cannot obtain records or talk to the treating physicians, which means they are being asked to make informed decisions with no information. A revocable trust handles assets and distribution and keeps the family out of probate. Pepe puts the threshold at a net worth over $250,000. He also has a practical fix for the conversation itself. A family at a bedside will answer for themselves without ever noticing they switched subjects, which is why a daughter says I want this while sitting in a room where the question was about her father. Ask them instead what they think he would have wanted, and Pepe says the answer arrives almost immediately. On how to raise it inside a 15- to 20-minute visit, his opener puts the stakes on somebody else. You're healthy now, you're stable now, and anything can happen, and this is for your loved one's sake. He says patients get receptive the moment it stops being about them. His ethical rule, from three decades of bedsides and boardrooms: "If you do what's right by the patient, you'll always be right." Listen to the full conversation on The Podcast by KevinMD. Link in the replies. What is the one document your patients are most likely to be missing when you actually need it? #AdvanceDirectives #ThePodcastbyKevinMD

🚨 BREAKING: Secretary RFK Jr. has DECERTIFIED Kentucky’s organ procurement organization Network for Hope after they IGNORED signs of life from SEVERAL patients scheduled for organ donations This is BEYOND evil. People should be LOCKED UP over this. Despite signs of life, the organization allegedly pushed for organ removals anyway. "Federal reviewers found serious deficiencies in nearly 30% of the cases that they examined" "We found repeated failures in clinical judgment, oversight, and patient safety, and we found that these problems continued even after the organization promised to correct them. These failures had real consequences."