These are folks that keep people out of hospitals, out of emergency rooms, out of nursing homes. And not only that, they help people achieve more fulfilling lives.

People underestimate the importance of dilligence as a virtue. No doubt it has something to do with how supremely mundane it seems. It is defined as "the constant and earnest effort to accomplish what is undertaken."... Understood, however, as the prerequisite of great accomplishment, diligence stands as one of the most difficult challenges facing any group of people who take on tasks of risk and consequence. It sets a high, seemingly impossible, expectation for performance and human behavior.

Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need.

These are folks that keep people out of hospitals, out of emergency rooms, out of nursing homes. And not only that, they help people achieve more fulfilling lives.

Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.

I talked to over two hundred patients and family members about their experiences with aging, serious illnesses, and the big unfixables. But I also spoke with scores of physicians, and especially geriatricians, palliative care doctors, hospice nurses, and nursing home workers. The biggest thing I found was that when these clinicians were at their best, they were recognizing that people had priorities besides merely living longer. The most important and reliable way that we can understand what people's priorities are, besides just living longer, is to simply ask. And we don't ask.

If the conversation people think is coming is the 'death panel' conversation, that's a total failure.