JAMDA Editorials Look at the Physician’s Role in Assisted Living
Two editorials in the February issue of JAMDA look at the physician’s role in assisted living (AL) communities and potential changes to ensure quality care in those settings. Both editorials note that there needs to be physician involvement in the care of AL residents, regardless of the state in which they reside or the regulations within that state. They also concur that good medical care involves a team that includes but goes beyond the physician.
In one editorial, authors Paul R. Katz, MD, CMD, Alan Kronhaus, MD, and Steven Fuller, MD, say, “Physicians expert in PALTC [post-acute/long-term care] are in an ideal position to effect positive change in AL communities. Many of the lessons learned in the nursing home over the past several decades can now be applied to AL to ensure consistency of care, adherence to applicable standards, and the provision of robust quality improvement programs.” Physicians, the authors suggest, can “contribute significantly to overall team function while advocating forcefully for their patients’ goals of care.”
In the other editorial, authors Barbara Resnick, PhD, CRNP, Josh Allen, RN, C-AL, and Ed McMahon, PhD observe, “When discussing the role of various health care providers, it is necessary to consider health care provision in terms of care needs.” They note that most AL residents have at least one chronic medical condition, with more than three-quarters having two or more such issues. These care needs, they say, “have implications for medical care, but require expertise and involvement beyond that of physicians.”
The editorial by Dr. Katz and colleagues suggests the need for greater physician direction and oversight in AL. Dr. Resnick and her co-authors observe, “Our vision…recognizes the broader health care team and the possibility that leadership may come from a non-physician professional.”