Reuters had an interesting article about a recent study showing that nursing home care is increasingly being delivered by specialized nurses and physician assistants instead of medical doctors.  “One of the problems is that many nursing homes have no regular doctors, since it is not a requirement,” Dr. Mitchell Katz, director of the Los Angeles County Health Agency told Reuters Health by email. “Most nursing home patients have a private doctor who signs the orders for the nursing care, but it is at an office where they may not be able to get to the nursing home on a regular basis.”

“In the past decade, the number of doctors in nursing homes has dropped as the number of “skilled nursing facility specialists” has almost doubled, the researchers report in JAMA Internal Medicine.”

The research team found that the proportion of physicians who had ever billed for care delivered in these facilities fell from 13.7 percent to 9.8 percent. Although the number of physicians classified as skilled nursing facility specialists rose from 1,496 to 2,225, that represented an increase from just 0.3 percent of all physicians to 0.5 percent.

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