Medical direction in long-term care.

This report presents the views of over 1000 administrators, nurses and physicians with respect to the responsibilities, authority and impact of the medical director in a long-term care facility (LTCF), as well as the nature and future of long-term care and geriatric medicine in the USA. Nurses, administrators and physicians were more able to agree on the bureaucratic functions of the medical director than on the functions which might be considered more clinical or activist in terms of the total needs of the LTCF. There was no consensus about the external factors which might determine the future of LTC, i.e. alternatives to institutionalization, public attitudes or community hospital relations. Instead, concern seemed to focus upon the "low level" of funding for LTC. With respect to the nature of LTC itself, most respondents felt that the area was clinically challenging. However, only 40 percent of the physicians believed that clinical skills were more important than a sympathetic regard for patients. As a corollary, physicians were the least supportive of geriatrics as a new specialty in medicine.