None of my seniors want to go to a nursing home. Being surrounded by screaming patients, the odor of incontinence, and the loss of dignity and independence make them cringe.
Primary care physicians (PCP) are reimbursed once-a-month for a visit, so the scope of medical care is minimal.
My suggestion: Develop public-private partnerships to fund for one year a recent PCP graduate who will serve in a nursing home seeing patients daily. These newly minted doctors can study for their Boards, have weekends off and set vacation time, but must round on patients and be on-call for problems. At the end of one year, an equal amount of salary will be awarded to pay back some of their medical school loans (which now can be greater than $200,000).
From this experience, young doctors will carry into their careers empathy for a vulnerable and growing group in society.
The odor may not change, but nursing home care could improve.
Gene Uzawa Dorio, M.D.