Factors affecting physician participation in nursing home care

Physicians generally consider nursing home practice a low priority compared with other aspects of their practices. In order to encourage more enthusiastic physician involvement, negative influences needed to be identified so that corrective ideas can be formulated. Negative factors include low reimbursement, frequent office interruptions, excessive paperwork, and a sense of loss of authority. The problem of quality physician involvement must be viewed from new perspectives. An increase in reimbursement is only part of the solution. Other measures that enhance the professional image and responsibility will increase physician participation more than laws and regulations, which increase physician time commitment without increasing reimbursement. Laws and regulations, through misperception, misinterpretation, and misapplication, can have unintended adverse results. Only creative solutions addressing identified negative factors will cut through the Gordian knot, which prevents enthusiastic and quality medical care for all NH residents.