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The Society of General Internal Medicine presented its 2012 Outstanding Junior Investigator Award to Rebecca Sudore, MD, a geriatrician at the San Francisco VA Medical Center (SFVAMC).

Dr. Sudore, who is also an Assistant Professor in Residence of Medicine in the Division of Geriatrics at the University of California, San Francisco, was cited for her “early career achievements and overall body of work that has made a national impact on generalist research.” She received the award at the Society’s Annual Scientific Meeting in May.

Dr. Sudore describes her research, much of which is supported by NCIRE – The Veterans Health Research Institute, as “creating interventions to improve informed medical decision-making for vulnerable older adults, especially those with limited literacy.”

A major focus of Dr. Sudore’s work has been advance care planning. This process, by which adults can designate a surrogate decision maker and communicate their wishes for end-of-life care, is often executed through an advance directive form. However, she says, “Most advance directives are written beyond a twelfth grade reading level, while the average reading level of US adults is only at the eighth grade.” To address the problem, Dr. Sudore created an advance directive written at a fifth grade reading level, with illustrations that explain the text. “We hope to be able to use this form at SFVAMC in the future,” she says.

However, said Dr. Sudore, “I realized that while there is a place for advance directives, they are not sufficient to prepare patients and their families for making complex medical decisions. There may be many different types of decisions, not just about CPR or mechanical ventilation, that need to be made over the life course.” In an attempt to identify how best to prepare patients and their families for complex medical decision-making, Dr. Sudore conducted a series of focus groups with Veterans and surrogate decision-makers. She is currently creating a health education intervention for Veterans based on these results.

Dr. Sudore concludes, “If we think advance care planning is important to discuss with our patients, we should focus not just on advance directives and end-of-life treatments, but also on preparing patients and family members to work with doctors and make informed medical decisions, based on their values, at the time they need to be made.”

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Society of General Internal Medicine

Rebecca Sudore, MD

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July 14, 2014