Physician Practice in Nursing Homes

The readers of this journal are undoubtedly familiar with the roles and responsibilities of physicians caring for nursing home residents. Whether through care guidelines promulgated through AMDA, certification requirements for medical directors, or the myriad of state and federal regulations, nursing home physicians clearly have a well-defined framework in which to practice. What strikes us as curious is the fact that many of these guidelines and policies are established and entrenched with little or no evidence base. Sadly, there is little in the way of an empirical literature that describes what physicians actually do in the nursing home and what impact their practices have on patient outcomes. Virtually nonexistent is any study of traditional “workforce” issues surrounding the training, recruitment, retention, and organization of physicians in long-term care settings. The papers and commentaries presented in this series attempt to address this gap by highlighting salient nursing home physician issues that were originally presented during a first-ever Consensus Conference on Physician Practice in Long-Term Care in Rochester, NY, April 2, 2004.