Dear Readers,

This is my 49th and last “Dear Dr. B” column, and I've decided to take the liberty of going beyond its regular format and addressing all of you, while reminiscing a bit about what goes into becoming and being a medical director.

—Dr. B

The first “Dear Dr. B” came out in January 2005. My tenure as editor in chief of CARING FOR THE AGES,... »

caring@elsevier.comDear Readers: My tenure as medical editor and columnist for CARING FOR THE AGES is coming to a close. This month and next, I'd like to tie up some loose ends. The December 2005 column, “The Reason Behind Routine Resident Visits,” generated the most comments, calls, e-mails, and requests for reprints of any I've written. So... »

Dear Dr. B.,Your strong endorsement of interdisciplinary team care is clear, and I found that the August Dear Dr. B column gave me a better understanding of the physician's role in IDT care. As an administrator, I would be interested in your thoughts on what expectations I should have for other members of our IDT.—J.G., Denver, Colo.Dr. B responds:... »

caring@elsevier.comDear Dr. B.: I have recently become the medical director of a 78-bed nursing home where I have worked as an attending physician for 11 years. I am now expected to be in the building for a weekly quality assurance meeting, but beyond that it's not clear to me what I'm supposed to be doing as medical director. What tips can you provide for... »

Dear Dr. B.: Recently, a resident of my facility was intubated in the hospital emergency department, despite the fact that her code status at her family's request was “do not resuscitate” and “do not intubate” (although there was no formal advance directive). This was upsetting to the family as well as to many hospital and nursing... »

caring@elsevier.comDear Dr. B.: My mother is having difficulty managing in her home of the past 37 years, and I am guessing she will need to move into an assisted living facility. As my mother and I visit facilities, what should we be looking for?—W.D., Pontiac, Mich.Dr. B responds: You have already made one good decision. It is clear from your... »

caring@elsevier.comDear Dr. B: As a nursing home medical director, I am aware of the importance of an interdisciplinary team approach in geriatric medicine in general and long-term care in particular. It seems, however, that this cooperative effort often runs very well without input from me or any other doctor, and I often feel like a fifth wheel when I... »