The Nursing Home Physician Workforce

Unlike a number of other health care professions practicing in nursing homes (NH), data specific to physicians is almost nonexistent. The only nationally representative study of physician practice in the NH was completed almost a decade ago and could not account for response bias owing to the nonrandom nature of the survey methodology employed.1 Nonetheless, only 1 in 5 physicians engaged in primary care noted involvement in NHs and spent an average of only 2 hours per week in the facility. No information was available in this study pertaining to physician-patient ratios in the NH or the mix of activities engaged in by physician providers.

Although NHs are required to provide staffing data on an ongoing basis through online survey and certification reporting (OSCAR), physician-specific data are suspect. Feng et al2 recently demonstrated the nongeneralizability of OSCAR-generated physician data when compared to information gleaned from an intensive survey of medical directors, directors of nurses, and administrators. In contrast, the nursing shortage in NHs has been confirmed by OSCAR and has provided the basis for new policy and program initiatives.