Steve Lai, MD - Long-Term Care Physician

As I walk into the SNF on Monday morning, 3 new patients were admitted over the weekend. I flip through the charts and find each patient has a POLST form with some sections completed along with a request for my signature. I wonder:

• Who had these conversations with the patient and family (If not documented on the back side)? Was it an informed, collaborative discussion?
• Were the decisions unequivocal?
• Does the patient have decision-making capacity (if they signed the form)?
• Did the surrogate make the decisions even though the patient has decision-making-capacity?

Flora Y. Brahmbhatt, PharmD, CGP
CALTCM Secretary & CALTCM Wave Associate Editor

Please provide a brief background of your training, practice setting and years in practice.

I have a Doctor in Pharmacy degree and I am a certified geriatric pharmacist. I have been working as a consultant pharmacist since 1999.

Please provide a brief background of your training and practice setting and years in practice.

I have been in private practice since 1996 and I am an Assistant Clinical Professor at the UCLA School of Medicine. As a multi-boarded physician, [board certified medical specialist in internal, pulmonary, sleep and geriatric medicine] I have an opportunity to see thousands of patients in the outpatient, inpatient, and nursing home setting. I continue to remain passionate about patient care and stand by giving my patients the care and time they deserve.

Jim Mittelberger, MD, MPH, CMD, FACP | Incoming CALTCM President

Those of us in long term care medicine have an extraordinary role to play in the future of American medicine. For years, progressively more complex and acutely ill patients have become the norm in our care in skilled nursing facilities, assisted living and home. Without much fanfare, with our active medical leadership, our SNFs and assisted living sites have adapted and developed much improved medical capabilities and quality.