Nursing Home Care Demand Increasing

Article excerpt

The graying of America places increasing demands on the shrinking number of physicians willing to care for nursing home patients, according to a University of Missouri-Columbia study. More than 1,500,000 people live in the nation's 20,000 nursing homes. That number is expected to hit 3,000,000 by the year 2020, when 55,000,000, or 18%, of Americans will be over age 65. The proportion of elderly is highest in rural areas.

The average doctor who tends patients in nursing homes is a primary-care provider (family physician, general internist, or osteopathic general practitioner) who has been licensed for less than 20 years and is just as likely as not to be board certified in a medical specialty. He or she averages six Medicaid patients, but some of his or her peers who are medical directors at nursing homes may care for up to several hundred patients at one or more facilities.

Although many younger physicians see nursing home residents, fewer medical graduates in recent years have chosen to go into primary care, resulting in a shortage of generalist doctors in some inner-city and rural areas as many of the older general practitioners retire. Of these newer doctors, many don't consider a nursing home practice attractive futility in not seeing patients' conditions improve, the need to see patients outside the office, and low Medicare and Medicaid reimbursements, notes Steven C. …