Content and boundaries of medicine in long-term care: physicians talk about stroke

Twenty physicians were interviewed about roles, treatments, goals, and relationships with older patients, especially stroke patients. Findings from this descriptive, anthropological investigation address the problem of congruence between needs and existing services, and in doing so, recast the ongoing debate about the medicalization of long-term care. This study emphasized the nonmedical features of geriatric medicine in general and stroke care in particular. In many instances, these physicians attempt to bridge gaps between medical and emotional needs and clinical and social services with social and psychotherapeutic as well as biomedical interventions. Because we found physicians' activities with stroke patients to be so broadly construed, treatment and management of stroke may be seen as paradigmatic for the role of physicians in long-term care.