RSS Feeds
Nursing Home Physician Specialists: A Response to the Workforce Crisis in Long-Term Care
- Paul R. Katz, MD;
- Jurgis Karuza, PhD;
- Orna Intrator, PhD; and
- Vincent Mor, PhD
- From the University of Rochester School of Medicine and Dentistry, Rochester, and State University of New York at Buffalo, Buffalo, New York; and Brown University, Providence, Rhode Island.
Abstract
Marginalization of physicians in the nursing home threatens the overall care of increasingly frail nursing home residents who have medically complex illnesses. The authors propose that creating a nursing home medicine specialty, which recognizes the nursing home as a unique practice site, would go a long way toward remedying existing problems with care in skilled nursing facilities and would best serve the needs of the 1.6 million nursing home residents in the United States. Reviewing what is known about physician practice in nursing homes and hospitals, and taking a lead from the hospitalist movement, the specialty would be characterized in 3 dimensions: the degree of physicians' commitment, physicians' practice competencies, and the structure of the medical staff organization in which they practice. Challenges to the adoption of a nursing home specialist model include mainstream medicine's failure to recognize the nursing home as a legitimate medical practice, the need for the nursing home industry and policymakers to appreciate the links between physician practice and quality, and assurance of financial viability. Implications for quality of care, health policy, and research needs are discussed in this article.
Article and Author Information
-
Grant Support: Dr. Katz was supported by the National Institute on Aging (grant R21 AG025246).
-
Potential Financial Conflicts of Interest: Consultancies: P.R. Katz (Omnicare Pharmacy and Therapeutics Committee board member).
-
Requests for Single Reprints: Paul R. Katz, MD, University of Rochester School of Medicine and Dentistry, 435 East Henrietta Road, Rochester, NY 14620; e-mail, Paul_Katz{at}urmc.rochester.edu.
-
Current Author Addresses: Drs. Katz and Karuza: University of Rochester School of Medicine and Dentistry, 435 East Henrietta Road, Rochester, NY 14620.
-
Drs. Intrator and Mor: Brown University, 164 Angell Street, Providence, RI 02912.
