The deck is stacked against physicians working in nursing homes:

All of this results in a significant amount of uncompensated care. Meanwhile, my elderly patients are living in their homes and independent living settings longer these days. That means the patients in nursing homes tend to be sicker and less medically stable, making more uncompensated work and more liability risk for the doctor . . .

. . . The homes rely on medical directors for supervising medical affairs at the home. But that’s a job that’s often more liability than it’s worth.

After a local home was fined by the state for failing to notify a doctor promptly about a sick patient, none of the doctors at the hospital wanted to be the medical director.

I decided the liability climate had become too risky even though I’d done the job at another nursing home before. They paid $400 per month to take calls when other doctors didn’t answer their pagers, take new patients that no one else wanted and attend staff meetings.