Many people wonder whether doctors make different choices about medical care at the end of life.
Because physicians understand diseases, treatments, and hospital systems better than most people, some believe they may prefer less aggressive care when they are dying.
A new large study suggests that doctors are indeed slightly more likely to die at home or in hospice rather than in a hospital, but the difference is smaller than many might expect.
The research was published online on February 24 in the medical journal Annals of Internal Medicine. The study was led by Dr. Vishal R. Patel from Harvard Medical School in Boston and his colleagues. The team wanted to find out whether physicians are more likely than other people to die at home or in hospice care.
Hospice care is a type of care that focuses on comfort rather than cure. It is usually offered to people who are nearing the end of life and want relief from pain and other symptoms instead of intensive hospital treatments.
Many surveys show that a large number of Americans say they would prefer to die at home if possible. However, in reality, many people still die in hospitals.
To answer their question, the researchers analyzed national data from the National Vital Statistics System. They looked at records of about 11.2 million people aged 30 and older who died between 2020 and 2023. Of these individuals, about 0.4 percent were physicians.
The researchers compared where physicians died with where people in other occupations died, including lawyers, engineers, scientists, registered nurses, other health care workers, and the general population.
After adjusting for factors such as age and other characteristics, the researchers found that 44.2 percent of physicians died at home or in hospice. In comparison, 40.6 percent of the general population died in those settings.
Among other highly educated professionals, 41.1 percent of lawyers, engineers, and scientists died at home or hospice. Among registered nurses and other health care practitioners, the percentage was 41.8 percent.
The pattern remained consistent across the six leading causes of death. Physicians had the highest percentage of deaths at home or in hospice for cancer, with 64.3 percent. For lower respiratory diseases, the figure was 52.3 percent. For heart disease, it was 47.4 percent.
For Alzheimer disease, 44.4 percent. For stroke, 41.9 percent. Even for COVID-19, 13.0 percent of physicians died at home or in hospice, which was still higher than in other groups.
These numbers suggest that doctors may be somewhat more likely to experience end-of-life care in settings that focus on comfort rather than hospital-based treatment. Some people may find this reassuring. It may indicate that physicians’ medical knowledge helps them make informed decisions that align with their preferences.
However, the researchers emphasized that the difference is modest. While physicians were more likely to die at home or in hospice, the gap between doctors and other groups was only a few percentage points. This means that medical knowledge alone may not be the main factor influencing where people die.
Many other elements can shape end-of-life experiences, including family support, access to hospice services, cultural beliefs, financial resources, and local health care systems.
When reviewing these findings, it is important to consider both their strengths and limits. The study included more than 11 million deaths, which makes it very large and statistically powerful. The use of national data increases confidence that the results reflect real patterns across the United States.
However, the study could not measure personal wishes directly. It does not tell us whether each individual achieved their preferred place of death. It also does not explain the reasons behind each decision.
The results challenge the common idea that doctors overwhelmingly avoid hospital deaths. While they do show a slightly higher rate of dying at home or in hospice, the difference is not dramatic. This suggests that end-of-life care is shaped by complex social and medical factors, not just by professional knowledge.
In summary, physicians are somewhat more likely than others to die at home or in hospice, according to research published in Annals of Internal Medicine. Yet the small size of the difference reminds us that improving end-of-life care for everyone will require broader changes in health systems, communication, and access to supportive services.
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