Physician Involvement in Long-Term Care: Bridging the Medical and Social Models

  • Robyn I. Stone
    Address correspondence to Robyn I. Stone, DrPH, Institute for the Future of Aging Services, American Association of Homes and Services for the Aging, 2519 Connecticut Avenue, NW, Washington, DC 20008-1520.
    Institute for the Future of Aging Services, American Association of Homes and Services for the Aging, Washington, DC.
    Search for articles by this author
      Long-term care is not easy to define. The boundaries between primary and acute and long-term care have become blurred.
      • Kane R.A.
      • Kane R.L.
      • Ladd R.C.
      • Stone R.I.
      It is not surprising, therefore, that there is no consensus on the extent to which physicians are, and should be, involved in long-term care delivery. The purpose of this article is to explore the current and potential role of physicians in long-term care and the challenges to their involvement, to identify models of successful physician engagement in long-term care settings, and to suggest strategies that should be explored to increase appropriate physician participation in the long-term care system to help adequately meet the demand for quality services in our aging society.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kane R.A.
        • Kane R.L.
        • Ladd R.C.
        The Heart of Long-Term Care. Oxford University Press, New York1998
        • Stone R.I.
        Long-Term Care for the Elderly with Disabilities. Milbank Memorial Fund, New York2000
      1. Centers for Medicare and Medicaid Services. Health and health care of the Medicare population, Table 4.B. Available at: Accessed May 2004.

        • Spillman B.
        • Lubitz J.
        New estimates for lifetime nursing home use: Have patterns of use changed?.
        MedCare. 2002; 40: 965-975
        • Kane R.L.
        • Kane R.A.
        • Finch M.D.
        • et al.
        SHMOs, the second generation: Building on the experience of the first social health maintenance organization demonstrations.
        J Am Geriatr Soc. 1997; 45: 101-107
        • Manton K.G.
        • Newcomer R.
        • Lowrimore G.
        • et al.
        Social health maintenance organization and fee-for-service outcomes over time.
        Health Care Financ Rev. 1993; 15: 173-202
        • Branch L.G.
        • Coulam R.F.
        • Zimmerman Y.A.
        The PACE evaluation: Initial findings.
        Gerontologist. 1995; 35: 349-359
        • Miller E.A.
        Federal and State Initiatives to Integrate Acute and Long-Term Care: Issues and Profiles. Congressional Research Report RL30813, Washington, DC2001
        • Kane R.L.
        • Flood S.
        • Bershadsky B.
        • et al.
        Effect of an innovative Medicare managed care program on the quality of care for nursing home residents.
        Gerontologist. 2004; 44: 95-103