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Study: Specialists would remedy long-term healthcare problems

A number of doctors write in a recent Annals of Internal Medicine study, providing personal physicians in nursing homes would increase the quality of care within the home.
 
 
 
A number of doctors write in a recent Annals of Internal Medicine study, providing personal physicians in nursing homes would increase the quality of care within the home. Considering there are countless Americans living in a long-term healthcare facility and the system is in desperate need of change, the idea may be a viable solution.

Currently there in the US there are 1.6 million living in nursing homes, with that number expected double by 2030. The system's "sicker but quicker" trend often sees many frail residents finding their ways to nursing homes after short hospital stays. The mortality rate in nursing homes is extremely high and expenditures currently exceed $120 billion per year.

Yet the problems are even worse than that. Among the twenty percent of physicians who practice in nursing homes, most say only four percent of their time dedicated to actual work. Worse, one-third of the 20 percent are actually internists. In summary, there could be much more done.

The doctors who wrote the report, Paul R. Katz, MD; Jurgis Karuza, PhD; Orna Intrator, PhD; and Vincent Mor, PhD, have a number of recommendations which include:


  1. "Creating a nursing home medicine specialty which would remedy the problems with care in skilled nursing facilities"

  2. "A proposal that nursing home specialists devote at least 20% of their practice to nursing home care"

  3. "Nursing home medicine would also require a more structured, "closed" medical staff model, which restricts privileges to a limited number of providers."



The report does admit there are a number of challenges which would need to be put in place to implement nursing home practice. They say one challenge is acceptance from mainstream media as well as recruitment and retention of a competent, trained workforce. Yet, the doctors say in the end it would be worth it.

"We contend that rather than accepting a diminished presence of physicians in nursing homes and finding alternative care models, it is time to fully consider, appropriately fund, and test the nursing home specialist model. If nearly half of the baby boomers spend some time in a nursing home, the question "Is there a doctor in the house?" will take on new urgency and meaning," the group writes in the report.

(For more information please see the report at http://www.annals.org/cgi/content/full/150/6/411)

Also check out our exclusive interview with S&R Nursing Homes Ltd. for a Canadian perspective of nursing homes.
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