In this article from our Health After 50 newsletter, Michele Bellantoni, M.D., Associate Professor of Medicine, Medical Director of Johns Hopkins Bayview Care Center, describes the unique type of care that geriatricians provide.
What is a geriatrician?
Geriatricians are doctors with specialized training in medical conditions and health care issues of older adults. As people age they tend to develop a number of coexisting health problems, which often require treatment with a variety of medications and frequent visits to different specialists. Geriatricians are trained to treat multiple health problems, keep track of multiple medications, and help patients who cannot function well to stay as independent as possible. We do this, in part, by creating a healthcare plan in coordination with other medical specialists and practitioners.
Who should see a geriatrician?
Generally it is the older adult with multiple medical conditions. For instance, patients may have heart disease or peripheral artery disease and neurological conditions, or they may have arthritis, diabetes, and vascular conditions that limit mobility. My patients range in age from the late 70s to 107. The oldest and most impaired don’t come to see me, since many can only walk a couple of steps, so I visit them in their homes.
What are the advantages to seeing a geriatrician?
We are particularly good at assessing physical function and are specially trained to recognize potentially adverse drug reactions and interactions in older people who metabolize medications differently and tend to take more of them. Also, we often have a health care team available to us that general practitioners and specialists do not have. For instance, we rely heavily on case managers, social workers, and nurses to follow up on the care plans that we’ve established in coordination with patients’ other doctors.
How can people find a practicing geriatrician?
Unfortunately, it is not easy to find a geriatrician. By all estimates there is and will continue to be a shortage of geriatricians in the United States. One reason is the sole practice of geriatric medicine does not pay as well as a medical practice that includes surgeries or invasive procedures.
The good news is that we are beginning to take steps to ensure that older people get the health care they need -- even if we continue to have a shortage of geriatricians. Medical schools now require students to receive training in geriatrics, and nursing schools are beginning to do the same. And many primary care doctors are not geriatricians but received continuing medical education in treating older patients with multiple medical conditions.
FOR MORE INFORMATION
• American Geriatrics Society (800) 563-4916 www.americangeriatrics.org • American Board of Family Medicine (877) 223-7437 www.theabfm.org • American Board of Medical Specialties (847) 491-9091 www.abms.org
