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Primary care for elderly people: why do doctors find it so hard?
Wendy L Adams1, Helen E McIlvain, Naomi L Lacy
1Department of Family Medicine, University of Nebraska Medical Center, 983075 Nebraska Medical Center, Omaha, NE 68198-3075, USA. Wadams@unmc.edu
The Gerontologist
|November 27, 2002
Summary
Caring for elderly patients presents challenges for primary care physicians due to medical complexity, personal issues, and administrative tasks. Addressing these can improve elder care delivery and physician satisfaction.
Area of Science:
- Geriatric Medicine
- Primary Care Physician Training
- Healthcare Delivery Systems
Background:
- Primary care physicians (PCPs) frequently encounter challenges when managing elderly patients.
- Understanding the root causes of these difficulties is crucial for improving geriatric care.
Purpose of the Study:
- To investigate and elucidate the specific reasons why PCPs experience difficulty in providing primary care to elderly patients.
- To develop a comprehensive conceptual model illustrating these challenges.
Main Methods:
- In-depth interviews were conducted with 20 PCPs.
- Grounded theory techniques and iterative analysis were employed by a multidisciplinary team.
Main Results:
- Three primary domains of difficulty were identified: medical complexity and chronicity, personal/interpersonal challenges, and administrative burden.
- The most significant difficulties arose when multiple domains overlapped.
- Practice environment, physician training, and personal values influenced the perceived difficulty of care.
Conclusions:
- Systemic changes in healthcare delivery and medical education are recommended to alleviate PCP difficulties with elderly patients.
- The developed conceptual model offers insights for informing necessary improvements in geriatric primary care.