Describing nursing home physicians with competence or focused practice in caring for older adults

Family physicians provide comprehensive medical care in nursing homes (NHs) as a core family medicine practice setting. NH residents receive regular medical care from their most responsible physician (MRP), who oversees, directs and manages daily care needs. Most NH MRPs are family physicians/general practitioners; some have “Care of the Elderly” certification reflecting enhanced skills training and additional competence to care for older adults. Family physicians in Ontario may also apply for a focused practice billing designation to increasingly care for older patients. Added competence/training and focused practice do not necessarily reflect provider quality in NH settings, although these physicians demonstrate some commitment to NH practice: they increasingly function as MRPs and complete more NH assessments. Yet, the NH MRP practice characteristics are largely unknown, including how they compare with other family physicians based on added training or focused practice. Such information may elucidate differences with educational, practice, and policy implications. Therefore, we compared provider- and practice-level characteristics of NH MRPs with/without added competence or focused practice.