Table 1.

Potential Barriers to Utilization of PC Services

Barrier	Mechanism
Disease	Unpredictable episodes of decompensation
Patient	Lack of knowledge of disease severity Uncertainty about prognosis Focus on liver‐saving interventions Distrust and misperception of PC (“death panels”)
Physician	Overestimation of life expectancy Misperception of PC Discomfort with end‐of‐life discussions Poor prognosis communication with patient Focus on liver‐saving interventions Confusion regarding indications for PC referral
Access	Improving, but potentially inadequate, access to PC services