Patient eligibility criteria. Inclusion criteria: (1) adults (≥ 21 years old); (2) metastatic solid tumors; (3) the oncologist "would not be surprised if the patient died in the next year"; (4) Eastern Cooperative Oncology Group performance status (ECOG PS) of ≤ 2; (5) planning to receive ongoing care from a participating oncologist and willing to be seen at least monthly.