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A Framework for Expectations of Physician Commitment in Long-Term Care Homes: A Consensus Statement.

Darly Dash1, Maya Potter2, Rebecca H Correia3

  • 1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Journal of the American Medical Directors Association
|November 16, 2025
PubMed
Summary

This study established consensus-guided expectations for primary care physician (PCP) commitment in Canadian long-term care (LTC) homes. The framework defines essential PCP roles, improving care quality and guiding future policy in LTC settings.

Keywords:
Long-term careconsensus methodsnursing homesprimary care physician

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Area of Science:

  • Gerontology
  • Health Services Research
  • Medical Education

Background:

  • Primary care physician (PCP) commitment is crucial for quality care in long-term care (LTC) settings.
  • Defining and measuring PCP commitment in LTC is complex and lacks consensus.

Purpose of the Study:

  • To establish consensus-guided expectations for PCP commitment in Canadian LTC homes.
  • To develop a comprehensive framework for understanding PCP commitment in LTC.

Main Methods:

  • A 2-round modified e-Delphi study involving 27 Canadian LTC PCPs.
  • Panelists rated 38 statements on relevance and feasibility using a 7-point scale.
  • Consensus was defined as ≥70% agreement; a virtual meeting facilitated revisions.

Main Results:

  • 21 statements achieved consensus, defining key expectations for PCP commitment in LTC.
  • Endorsed expectations include time allocation, on-site presence, resident load, collaboration, and specific care approaches (medication management, palliative care).
  • Statements not endorsed related to the number of LTC homes served, experience, certifications, leadership, or research.

Conclusions:

  • This study provides the first consensus-based framework for PCP commitment in Canadian LTC.
  • The framework enhances understanding and measurement of physician involvement in LTC.
  • It is crucial for improving LTC quality, guiding policy, setting standards, and informing future research on resident outcomes.