Promising Practices in Long-Term Residential Care: Where Do Physicians Fit In (or Don’t They)?
Bibliographic record
Abstract
Compared to a decade ago, long-term care residents are likely to be older, frailer, more functionally impaired, more medically complex, and closer to the end of life. Because of this, residents are also less likely to benefit from and more likely to be harmed by the same drugs and routine medical interventions that may have worked well for them earlier in life. Family physicians are well positioned to play a key role in navigating the tensions between life extension, rehabilitation, symptom management, and palliation. Unfortunately, in many jurisdictions, despite more than a decade of primary care reform, family physicians are not attracted to working in long-term residential care (LTRC). The proportion of those working in LTRC has been declining over time, and there is no mandatory training of family physicians in LTRC work. This article reviews the influence of Canadian primary care policy related to the physician role in LTRC facilities and describes a number of promising practices across Canadian provinces to engage them in LTRC teamwork.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.033 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.025 | 0.010 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".