Nursing home specialists: Can they improve care?

If you’re thinking about ways to improve your nursing facility’s care, you might want to examine your facility’s relationships with physicians.

Taking a cue from the hospitalist model, which created a physician specialty around a site of care, physician nursing home specialists may improve the quality of care in nursing homes, says Paul R. Katz, MD, professor of medicine and chief of the Division of Geriatrics and Aging at the University of Rochester School of Medicine and Dentistry.

Katz is the lead author of a recent Annals of Internal Medicine article proposing the concept of nursing home specialists to promote physician involvement in long-term care.

Under the proposed model, nursing home specialists would be asked to commit 20% of their practice to nursing home care and demonstrate competency in nursing home medicine. The article also recommends instituting a “closed” medical staff model in nursing homes, which Katz says could lead to improved efficiency, quality care, and resident satisfaction by limiting facility privileges to a small number of physicians. A closed staff model also allows physicians to become “embedded in the culture of the facility and understand the philosophy of care.”

Katz says he hopes as physicians participate in closed staff models, evidence will show improvements in the quality of care and nursing home administrators will recognize the value of physicians working closely with nursing facilities and seek out this kind of care.

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