The Role of Physicians in Long-Term Care: An Interview with a Board - Certified Practitioner

Note from Author, Kris Reyes :

I've always been curious about the thoughts and perceptions people have regarding "nursing homes" and "long-term care". To provide a deeper understanding of these concepts, I'm introducing a monthly feature that will shed light on long-term care, featuring insights from experts immersed in the field. My goal is to humanize our industry's perception during this healthcare season and to hear your thoughts, whether you're involved in the long-term care field or an outsider looking in.

To kick off this column, I'd like to share insights into the ever-changing role of physicians in Long Term Care. I recently had the opportunity to meet with Dr. Owrang Dastmalchi, a board-certified internal medicine professional and a valuable member of the Trabuco Hills Post Acute Care team in Lake Forest, California. We met on a Friday morning and, as anticipated, calls started coming in as soon as Dr. Dastmalchi sat in our conference room at the Brea office. He quickly answered a few calls and apologized for the interruption.

Jokingly, I asked if a work-life balance still existed for him, now that he practices both internal medicine and long-term care. "Have you been talking to my wife?" He laughed, putting on his glasses and refocusing on me. "I've known what I wanted to do since I was five years old, and this," he said, pointing to his phone, "is my passion and my desire."

Dr. Dastmalchi has been practicing medicine for more than 20 years, starting with his residency at Highland Hospital in Oakland, California. His experience spans treating conditions from simple coughs to gang-related shootings. Board-certified in internal medicine, he visits multiple hospitals in Orange County and collaborates closely with his colleagues at Paloma Medical Group. He is currently a physician at Trabuco Hills Post Acute. Treating seniors has reminded him of why he originally chose to become a physician.

"I grew up in the Middle East. My grandmother, who lived in a small village in Kurdistan, had an accident where she fell from a two-story building. She broke her back and, due to the lack of resources and healthcare in her area, became paraplegic. Ever since that accident, I vowed to become someone who could help people."

Dr. Dastmachi's interest in long-term care grew upon becoming a Hospice and Palliative Specialist. He has always appreciated the continuum of care, making long-term care a logical progression in his career.

"Skilled Nursing Facilities are crucial in completing the continuum of care for patients. Despite long-term care's historical association with poor quality and outcomes, I've observed a significant improvement in the quality of care in these facilities over the past 20 years. Trabuco Hills exemplifies skilled professionals collaborating to enhance our patients' quality of life.”

Dr. Dastmachi sees Long Term Care as crucial for seniors with escalating comorbidities in acute care. In this setting, social issues such as home support and medication access can be overlooked when the focus is primarily on patient stabilization. This group is at high risk of rehospitalization, hence a physician who understands safe patient reintegration is crucial.

"Eighty percent of healthcare dollars are spent on 20% of the population in the last two years of their life. This statistic shocks me. That's why the active involvement of physicians who understand how to transition seniors across different care continuums is crucial."

Dr. Dastmachi aims to enhance senior care by addressing current healthcare system shortcomings. He believes improving communication between care settings is crucial, and he has seen his patients' experiences improve significantly in long term care, by managing their transition from acute care, to nursing facilities, and back home.

"I urge physician to get involve in long term care. I've learned so much from the Trabuco Hills team on how to better advocate for my patients. Over the years, hospitals and SNFs have been separated by protocols and languages unique to each care setting. This often causes confusion when transitioning a patient from one care setting to another. For instance, a cardiac protocol at a hospital may not translate in the same way to a SNF setting. The more time I spend in both care settings, the more I realize that involvement in long term care is not just a goal, but a necessity.”

“We owe it to our seniors to provide the best care possible,” he emphasizes. “I believe this can be achieved through partnerships and collaboration."