Bob James Joel Lexchin Margaret McGregor Which Categories Should Be Present amp Why Doctors Legislation in at least three Canad i an provinces requires a medical director Not necessarily the case in other countries ID: 157006
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Slide1
Skills for Long-Term Residential Care: Doctors
Bob James
Joel Lexchin
Margaret McGregorSlide2
Which Categories Should Be Present & Why
Doctors
Legislation in
at least three Canad
i
an provinces
requires
a medical
director
Not necessarily the case in other countries
Doctors needed for medical decision-
making
Some could be
done remotely
by
RNs
but doctors would be uncomfortable if
they were not physically present some of the time
In some provinces NPs can fulfill doctor role
Can sometimes help avoid hospitalizations and complicationsSlide3
Question – Level of Training & Full
vs
Part-time
Type of doctor
General Practitioner
Geriatrician
Full
time
Geriatric
training
No geriatric training
Yes
?
?
?
No
?
?
?Slide4
How Should Work Be Divided & Coordinated
Doctors typically do things such as admission physicals, annual reviews and medication
reviews
Ideally provide pro-active longitudinal care & develop relationships with residents & families
Provide care for acute events on a 24/7 basis
Medical
directors, where present,
in Canada coordinate work of all doctors
In other countries may be done by administrators
In some LTC homes Medical
Advisory Committee
generates
medical policy
Doctors & other care staff
Communication with senior nursing staff usually face-to-face
Communication with other staff through
“
communication book
”Slide5
Questions
Should doctors just be involved with narrow medical issues or wider social issues?
How do doctors organize their time in the nursing home versus what nurses need in terms of doctor time
?
Who should doctors be accountable to?Slide6
Gender and Racialization
Primarily older white male doctors versus primarily female staff often from developing world countries
Administrative and leadership staff tend not to come from visible minoritiesSlide7
Questions
Are these differences expressed in power
relationships?
Do female doctors interact differently with other staff & patients compared to male
doctors?