This document discusses the need for life planning, also known as Rest of Your Life (ROYL) planning, given the aging Baby Boomer population in the U.S. It notes that while ancient cultures planned for death, and Greeks had beliefs about the afterlife, today only a small percentage of Americans have advanced directives. The document outlines how the author, a surgeon, became involved in ROYL planning after realizing doctors are often uncomfortable discussing end-of-life issues with patients. It argues that ROYL planning can improve quality of life and patient satisfaction while reducing healthcare costs.

1. Life Planning #1/ Put Your
House In Order
 Philip Lisagor, MD, FACS
 www.TheROYL.com

2. Where Are We?
 10,000 Americans turn 65 every day and this
will continue until 2031
 This encompasses 78 million Americans born
between 1946 and 1964/ aka Baby Boomers
 Baby Boomers are currently taking care of their
parents and often of their children in today’s
economy
 One in 5 Americans have advanced directives,
and 1 in 5 of them have it available for 1/25

3. Where Did We Come From?
 Egyptians, at least the wealthy, planned
for their deaths in advance

4. Ancient Hebrew Patriarchs
So did the Hebrew Patriarchs: Abraham,
Isaac and Jacob

5. Greek Thoughts
 Greeks had Hades, abode of the dead
 Charon, ferryman, for the River Styx
 Coin placed in mouth of the dead to pay
Charon

6. How Did We Get to Today?
 Dissolution of extended family
 Belief in science and medicine
 Evolving complexities of everything!

7. How Did I Get Involved?
 MD 72, University of Chicago
 Career in surgery/ general, thoracic,
cardiac including thoracic oncology
 That means lung cancer!
 Long trip to actually talking with patients,
their families and loved ones

8. Why Don’t Doctors Talk to
Patients?
 Not trained
 Had seminar with Elizabeth Kubler-Ross in Medical
School, “Of Death and Dying” 5 steps of Grief
 Uncomfortable
 Dealing with failure
 Dealing with their own mortality
 Feeling they have nothing to offer
 Takes time and isn’t included in government or
insurance billing codes

9. Ostrich Effect

10. Development of ROYL
 Rest of Your Life planning
 Toolkit for Doctors
 Aimed an End of Life Planning
 Expansion to Stakeholders
 Expansion to Rest of Your Life planning

11. Benefits of ROYL
 Improved quality
 Improved patient/family/loved ones
satisfaction
 Reduced cost of health care
 US #1 in cost
 US #7 in benefits
 Growth not sustainable (16% GDP currently)

12. Risks of Failure to do ROYL
 Decreased quality
 Decreased satisfaction
 Increased costs-50 billion/year
 Someone will do planning for you, loss of
patient autonomy
 Death panels argument
 Why?
 Who?

13. ROYL
 Legal documents
 Personalized information sheets
 Personalized process action check list
Cultural Change-possible with current
economic imperative of the graying of the
boomers!

14. WWW.TheROYL.com