With a shortage that’s growing you’ll see a geriatric specialist selectively.
Geriatricians have become more important as the huge wave of Baby Boomers slides into old age, but you don’t necessarily need to see one.
A geriatrician is a physician who has completed a residency in either internal medicine or family medicine with an additional one to two years of training fellowship in the needs of older adults. They also often work with a team of other healthcare professionals like geriatric-trained nurses, rehabilitation therapists, nutritionists, social workers, and psychiatrists to provide care. In addition, they’ll coordinate treatments among a patient’s specialists.
Two seniors aged 70 could have very different health needs or disability. You could be perfectly healthy while your friend next door could have serious health problems. Many seniors take a dozen or more medications each day. This polypharmacy and potential interactions is where a geriatrician plays a crucial role in treating often complicated medical problems.
Geriatricians also are most familiar with the resources in a particular geographic area that you might need and can make referrals to specialists you might need to see.
Coincidentally, however, the number of doctors who specialize in geriatric medicine are going down as the number of the oldest old is going up.
“We are not prepared as a nation. We are facing a crisis,” Heather Whitson, MD, associate professor of medicine at the Duke University School of Medicine in Durham, North Carolina tells U.S. News. “Our current health care system is ill equipped to provide the optimal care experience for patients with multiple chronic conditions or with functional limitations and disabilities.”
There are more than 7,500 certified geriatricians in the U.S. But 17,000 geriatricians are needed to care for about 12 million older Americans, according to projections by the American Geriatrics Society (AGS). The AGS says about 30 percent of the patient population 65 and older will need a geriatrician and that one geriatrician can care for 700 patients.
Board-certified geriatricians told Very Well that they enjoy the challenges the older population presents, particularly because medical, social, and psychological problems with seniors tend to be intertwined. That makes their practices, they say, truly holistic.
There was the case of an elderly patient who was losing weight, says Rahmawati Sih, MD, medical director of a Chicago-area nursing home and private practitioner.
It turned out the patient did not like to cook for herself and had challenges getting out to buy food. Physical limitations kept her from cooking for herself in any case.
This is an example of the issues geriatricians face all the time, and through training and experience they know how to deal with them. That’s not to say a primary care physician couldn’t have deduced the problem, but the chances are less likely.
Right now, with a the limited number of geriatricians available, patients most likely to benefit from seeing one include the frailest old with multiple medical problems, older adults with multiple medical problems and limited social support, and older adults with medical problems primarily associated with aging. To find one visit Medicare’s online Physician Compare tool.
July 22, 2016
Janet O’Dell, RN