Evaluation of an Open and Closed Medical Staff in a Nursing Home Setting

Miller, Dulcy B.; Keller, Dorothy Smith; Woodruff, Shirley

doi:10.1093/geront/14.2.158

Cited by 4 publications

(3 citation statements)

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“…Miller et al 6 interviewed nursing home administrators and physicians and uncovered the following barriers that prevented physicians from providing quality medical care to the nursing home resident: physician disinterest in caring for the nursing home population, difficulty in developing definitive care programs, and ineffective interpersonal communication with nurses.…”

Section: Physician's Role In the Nursing Homementioning

confidence: 99%

The Nursing Home Medical Director

Fanale

1989

J American Geriatrics Society

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Section: Physician's Role In the Nursing Homementioning

confidence: 99%

The Nursing Home Medical Director

Fanale

1989

J American Geriatrics Society

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“…D. B. Miller (5) suggested the advantages of a closed medical staff. Under such circumstances, medical care is likely to be superior, as physicians are selected on the basis of proven interest and competence in geriatric medicine.…”

Section: Review Of the Literaturementioning

confidence: 99%

Physicians' Attitudes Toward the Ill Aged and Nursing Homes*

Miller

Lowenstein

Winston

1976

J American Geriatrics Society

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A survey of physicians in private practice (exclusive of pediatricians) was conducted in a medium sized suburban city in the New York metropolitan area, to determine whether physicians' attitudes toward the ill aged and nursing homes were predictors of the quality of medical care available to area nursing home patients. Questionnaires were circulated to 302 practitioners. Of the 28 percent who responded, 32 percent were psychiatrists, 15 percent primary care physicians and 8 percent orthopedists. Physicians felt competent to manage the ill aged, although 50 percent had had no significant degree of exposure to geriatric medicine in their medical education, and 70 percent of the primary care group had had none. Primary care and older physicians were more likely to treat patients in nursing homes. Almost 40 percent viewed the nursing home as a place to die. Although 85 percent studied that physicians should be involved in the nursing home displacement process, only 21 percent believed that they continued to be in charge of their patients after placement. The findings demonstrate generalized medical disinterest in the care of ill aged patients in institutions. The persons responsible for awarding government grants and those involved in planning medical school curricula should pay more attention to the needs of the chronically ill aged.

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“…Despite this policy interest, there has been little empirical research exploring the activities of medical administrators in long-term care facilities. With a few exceptions (McKibbin, 1978;Elon, 1993) most of the articles focusing on this issue have been largely advocacy in nature and relied on opinion analysis rather than empirical assessment (Solon, 1963;Mark, 1968;Miller, Brimigion, & Keller 1972;Isack, 1973;Miller, Keller, & Woodruff, 1974;Tessaro, 1974;Moss, 1975;Lawson, 1976;Miller, Lovenstein, & Winston, 1976;Miller, 1976;American Medical Association, 1977;Brimigion & Feldman, 1977;Pattee, 1980Pattee, ,1983Collins, 1982;Mitchell, 1982;Mitchell & Hewes, 1986;Bladek, 1989;Fanale, 1989;Levenson, 1989;Ouslander, 1989). Further, although various guidelines have articulated what are thought to be key functions of the medical administrative role, few studies have explored empirically the extent to which guidelines are adhered to in practice.…”

Section: Introductionmentioning

confidence: 99%

The Medical Administrative Role of Medical Directors and Advisory Physicians in Ontario Nursing Homes and Homes for the Aged

1995

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A self-administered mailed questionnaire was sent to a stratified random sample of medical administrators in Ontario homes for the aged (HFAs) and nursing homes (NHs) in 1991 in order to explore the types and extent of medical-administrative activities undertaken by these physicians, and their perceptions of skills, attitudes and knowledge that were important in carrying out their roles. Three key findings emerged from the survey. First, considerable variation exists in the extent of medical administrative activities undertaken within each of the two facility types and, in some cases, across the two facility types. Second, there were few activities which ≥75 per cent of medical administrators reported undertaking on all occasions and many activities which ≥25 per cent of physicians reported not undertaking on any occasion. Third, in general, medical administrators did not express values congruent with adoption of a broader management role in facility administration, financing, and planning activities. Research and policy implications for the evolving role of medical administrators in NHs and HFAs are discussed.

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Evaluation of an Open and Closed Medical Staff in a Nursing Home Setting

Cited by 4 publications

References 0 publications

The Nursing Home Medical Director

The Nursing Home Medical Director

Physicians' Attitudes Toward the Ill Aged and Nursing Homes*

The Medical Administrative Role of Medical Directors and Advisory Physicians in Ontario Nursing Homes and Homes for the Aged

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