There is a growing call for nursing homes to be required to employ full time physicians to care of their residents. Currently, when a patient enters a nursing home, they keep their primary care physician (PCP). There are always problems with any new idea, but I want to focus on two at this time.
The foremost problem I forsee is that nursing home residents and physicians both want to keep their relationship. By the time that a person is ready to enter a nursing home, they usually have a long relationship with their PCP.
The problem with the current system is that the average nursing home resident is no longer easily able to transport themselves to their doctor’s office. At the same time, a doctor who spends his day traveling to a nursing homes to see individual residents will quickly find his or her practice shrinking radically.
Instead, nurses at nursing homes act as a doctor’s eyes and ears. Unfortunately, many highly trained Registered Nurses (RN) are placed in administrative roles, leaving the vast majority of resident interaction to certified nurse aides (CNA).
In theory, CNA conduct daily examinations and treatment for nursing home residents. When they observe a health issue, they send notifications up the chain of command in the nursing home to a trained nurse who notifies the resident’s PCP. The PCP responds to written notes, charts, test results, and other second or third hand data to diagnose the issue and order treatments.
Rarely, however, does the physician actually visit the patient. As a Chicago nursing home lawyer, I’ve spoken to many doctors who were never notified as the health of their patient deteriorated. Sometimes, even when the doctor is notified, but the seriousness of the condition is downplayed.
Without a personal examination, no doctor can be certain of their patient’s condition.
The second obstacle I see to requiring nursing homes to employ medical doctors is a mixture of fact and fiction.
One of the commonly cited reasons for allowing nursing homes to avoid employing full time physicians is the looming physician shortage in the United States. The cause of the shortage is clear – the retirement of the baby boom generation. As people get older, they need more medical care.
The shortage is very real, but according to the Association of American Medical Colleges (AAMC), medical enrollment is set to meet a 30% increased medical school enrollment goal set in 1996 for 2016. In short order, there will be thousands of new physicians graduating from medical school. Will it be enough to meet the demand? That remains to be seen.
The idea of requiring thousands of doctors to be employed in nursing homes is, I believe, going to eventually be a reality, but not for another decade or two.. The early baby boomers (born in 1946) are only now turning 70. The average lifespan in the United States is 78.
A few decades from now, the largest portion of the population will be over 80 years old. Many of them will require nursing homes or assisted living facilities. Eventually it will no longer be feasible to keep medical doctors out of the facilities where so many of their patients are living.
In the meantime, nursing homes continue to operate in conditions that range from exemplary to criminal. When the majority of the population begins residing inside them, it’s possible that current laws and standards will change.
In the meantime, our Chicago nursing home lawyers continue to fight nursing homes on behalf of residents who have suffered from neglect or abuse . If you have a loved one who has been abused or neglected in an Illinois nursing home, contact my law offices for a free and confidential evaluation of your case.