Task Study Addresses Core Skills, Activities of Attending Physicians in Post-Acute and Long-Term Care
A unique job analysis conducted by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) highlights the unique and specific role of the post-acute and long-term care (PALTC) attending physician in the provision of medical care across PALTC settings. According to an article in JAMDA, these findings lay a foundation for recognizing PALTC medicine as a specialized area of medical practice, perhaps leading to a focused practice designation in PALTC, as well as changes in practice and/or policy.
In Defining the Core Skills and Activities of the Attending Physician in Post-Acute and Long-Term Care, the authors describe a survey of attending physicians addressing a list of tasks, experience, and medical knowledge needed in their role in PALTC. These items, developed and refined by a task force of subject matter experts, were written as statements that described distinct, identifiable, and specific practice-related activities relevant across multiple sessions. In all, the survey consisted of 260 items.
The results showed that attending physicians supported statements related to ethical and culturally sensitive conduct, including applying principles of shared decision-making, to achieve patient- and resident-centered approaches to care. They also ranked knowledge relating to maintaining good facility coverage highly. Top-ranked medical care delivery statements included recognizing, assessing, and treating patients and residents in a timely and non-disruptive manner, and ensuring continuous medical coverage.
Top-rated medical knowledge tasks involved using individualized information about comorbidities and risk factors to evaluate symptoms, as well as developing and following plans for additional and regular patient evaluation and re-evaluation. This includes deprescribing medications whenever possible. In support of these tasks, knowledge of differential diagnosis, deprescribing, pain management, multiple morbidity, and the use of decision-making tools were all highly rated.
The authors suggested, “Physicians should undergo an effective educational process to learn the requisite knowledge to perform necessary roles and tasks in this specialized area of medicine. This process should also include training about the settings and systems of care and methods for improved collaboration with the interdisciplinary team to provide person-centered care.” They further noted that the survey results may be helpful for curriculum development in medical and nursing schools.
The study was conducted by researchers at the University of Louisville School of Medicine, Louisville, KY; University of Rochester School of Medicine and Dentistry, Rochester, NY; Eastern Virginia Medical School, Norfolk, VA; and Florida State University School of Medicine, Tallahassee, FL.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles, including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.