Radiotherapy is highly effective at palliating malignant sources of pain. However, once enrolled on hospice, patients are rarely referred for this treatment. To develop effective educational strategies that can increase access to care, a survey of hospice providers investigated potential misconceptions about its' benefits and availability. Methods: Individual surveys to hospice administrators, nursing directors, and medical directors at 16 licensed hospices within 25 miles of a radiation

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... y facility. Results: 93% of hospice professionals stated radiotherapy provides pain relief, and is appropriate for patients with > 1 month of life expectancy. However, less than 1% of their cancer patients had been referred to a radiation oncologist over the past year, citing concerns about travel burden and cost. While most medical directors (75%) were aware it is just as effective when delivered in a single fraction, very few administrators (22%) and nursing directors (21%) had this knowledge. Meanwhile, reluctance of a radiation oncologist to offer single fraction palliative radiotherapy was experienced by 43%. Conclusion: Access to palliative radiotherapy for this unique population may be increased by improving education for hospice administrators and nursing directors, and reminding radiation oncologists that single fraction palliative radiotherapy is acceptable, and ideal, for patients with limited financial resources who are near the end of life.