AI Article Synopsis
- The study aimed to explore how experienced physicians perceive the role and value of SNFists (physicians who mainly work in skilled nursing facilities) in nursing home care.
- Participants were 35 physicians with significant experience in nursing homes, interviewed virtually.
- Key themes emerged, highlighting issues like the lack of clear definitions for SNFists, the unique competencies required for effective practice, and the potential benefits they bring to patient care, despite challenges such as lack of billing for certain services and care continuity.
Article Abstract
Objective: To identify the perceptions of physicians with expertise in nursing home care on the value of physicians who primarily practice in nursing homes, often referred to as "SNFists," with the goal of enriching our understanding of specialization in nursing home care.
Design: Qualitative analysis of semistructured interviews.
Setting And Participants: Virtual interviews conducted January 18-29, 2021. Participants included 35 physicians across the United States, who currently or previously served as medical directors or attending physicians in nursing homes.
Methods: Interviews were conducted virtually on Zoom and professionally transcribed. Outcomes were themes resulting from thematic analysis.
Results: Participants had a mean 19.5 (SD = 11.3) years of experience working in nursing homes; 17 (48.6%) were female; the most common medical specializations were geriatrics (18; 51.4%), family medicine (8; 22.9%), internal medicine (7; 20.0%), physiatry (1; 2.9%), and pulmonology (1; 2.9%). Ten (28.6%) participants were SNFists. We identified 6 themes emphasized by participants: (1) An unclear definition and loose qualifications for SNFists may affect the quality of care; (2) Specific competencies are needed to be a "good SNFist"; (3) SNFists are distinguished by their unique practice approach and often provide services that are unbillable or underreimbursed; (4) SNFists achieve better outcomes, but opinions varied on performance measures; (5) SNFists may contribute to discontinuity of care; (6) SNFists remained in nursing homes during the COVID-19 pandemic.
Conclusions And Implications: There is a strong consensus among physicians with expertise in nursing home care that SNFists provide higher quality care for residents than other physicians. However, a uniform definition of a SNFist based on competencies in addition to standardized performance measures are needed. Unbillable and underreimbursed services create disincentives to physicians becoming SNFists. Policy makers may consider modifying Medicare reimbursements to incentivize more physicians to specialize in nursing home care.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9342866 | PMC |
| http://dx.doi.org/10.1016/j.jamda.2022.03.008 | DOI Listing |
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