WHO SPEAKS FOR YOU IN A MEDICAL CRISIS?

In a medical crisis—when seconds matter and emotions run high—one question can change everything: who speaks for you when you can’t? For years, that responsibility has fallen to loved ones, often unprepared and left to navigate complex decisions without clear guidance. After 15 years in internal medicine, Dr. Chris Sepich witnessed the consequences firsthand. From ICU rooms to hospice care, he saw families struggle to interpret a patient’s wishes—sometimes leading to delayed care, fractured relationships, or even legal battles. Now, he’s stepping in with a first-of-its-kind solution.

With the launch of Your HCPOA in Wilmington, North Carolina, Dr. Sepich is introducing the nation’s first physician-directed Health Care Power of Attorney service. The model brings medical expertise directly into one of life’s most critical moments—easing the burden on families and ensuring decisions are guided by both clinical insight and a clear understanding of what matters most.

What specific experiences as an internal medicine physician made you realize the need for this service?

I had many patients without anyone they could confidently rely on to make healthcare decisions. Some ended up hospitalized with no decision-maker at all—staff were calling numbers and even searching Facebook to find someone. When they did, that person was often unprepared. One of the most difficult cases was a mother in the ICU after a stroke. Her daughter was named as her healthcare power of attorney, but they had never discussed her mother’s wishes. The daughter wanted to do the right thing, but didn’t know what that was—and she questioned her decisions long after her mother passed. I wanted to relieve that kind of burden.

Leaving a long-standing practice is a big decision. What was that transition like?

It was incredibly difficult. I built strong relationships with my patients over 15 years, and stepping away from their care was not easy. It still isn’t. But I realized that while there are physicians to treat patients, there’s no one to advocate for them once they lose their decision-making capacity. This work allows me to fill that gap—using my medical training and experience serving as an HCPOA agent for others who were not my patients. My wife, Jody, who is also an internist, played a key role in helping shape a model designed to minimize risks and failures in the current system.

How does a physician-directed HCPOA differ from traditional models?

I focus solely on healthcare decisions—not legal or financial matters. I understand medical terminology, can assess the prognosis, and recognize the variables that influence outcomes. Just as importantly, I remain objective. In high-stress situations, loved ones can struggle to process information. My role is to interpret what’s happening, ask the right questions, and advocate clearly for the patient’s wishes—without emotional or external pressures. Through in-depth conversations, I help clients define their values and treatment preferences so there’s no guesswork later.

Can you share an example of how this approach makes a difference?

An older patient was undergoing a urologic procedure. During surgery, the physician discovered a concerning mass. I was contacted to make a decision while the patient was still under anesthesia. Because I understood his wishes and the medical implications, I was able to authorize immediate removal. That avoided a second surgery and the risks that come with stopping medications again. He recovered without complications and returned to his life. It was a clear example of how timely, informed decision-making can change outcomes.

What challenges do you see for Wilmington’s growing retiree population?Many residents don’t have family nearby, which can delay care if a decision-maker can’t be reached. In some cases, hospitals rely on default consent laws or pursue guardianship, which can lead to more reactive, less personalized care.

Another issue is outdated documents. Someone may have named an agent years ago who no longer understands their current wishes. Without clarity, important decisions are left to guesswork—often resulting in care people may not want.

Looking ahead, how do you hope this changes healthcare decision-making?My goal is to move beyond the current system that relies solely on family and friends, and instead incorporate medical professionals who understand clinical realities and stay updated on a patient’s wishes. Ultimately, I hope more people have an advocate who is informed, available, and aligned with their values—so they can have peace of mind knowing their wishes will be honored, even if they can’t speak for themselves.

To Find Out More Information Visit YOUR HCPOA.