Geriatrics Interest Group
As future physicians who will be caring for an aging population, we all have an obligation to seek the expertise necessary to treat older patients with skill, sensitivity and dignity. Almost every medical specialty will have an increasingly older patient base, thus if we are aware of the issues specific to the geriatric population and we are trained to work with older patients, we will be better physicians.
"Geriatrics" is medical practice that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease. It requires an interdisciplinary approach - we will work with other physicians, nurses, social workers, occupational therapists and family members, in order to provide comprehensive care for these patients with multiple needs.
Geriatric medicine is its own specialty. After an internal medicine or family practice residency, physicians can complete a one or two year fellowship to become certified in geriatrics. Geriatricians are primary care doctors for older patients and can also serve as consultants to other physicians and to hospital programs that work with the elderly. Psychiatrists can also complete a fellowship to specialize in geriatric psychiatry.
Source: The Administration on Aging's "A Profile of Older Americans: 2004"
Why Should I Be Interested in Learning About Older People?
THE REALITY OF CHANGING DEMOGRAPHICS
As a health care provider, you will be dealing with elderly people no matter what specialty you choose, even pediatricians deal with the unique issues of grandparents raising grandchildren. The demographics of the United States are changing. Between 2010 and 2030, the population over 65 will increase by 73%! Seventy million people (One out of every five Americans) will be over 65. The number of older patients each physician sees, thus, is increasing. No matter the percentage of older patients you have in your caseload, you will see them more often and spend more time with them due to their increased likelihood of multiple chronic conditions.
GERIATRICS IS UNIQUE. YOU'LL NEED SPECIAL TRAINING
Treating geriatric patients requires a different strategy and is very complex. Additional training and focus is needed, or you risk making errors. For example, common errors include causing iatrogenic problems by polypharmacy or by prescribing normal adult doses to elderly patients.
YOU'LL BE A BETTER DOCTOR
Taking an interest in geriatrics will enable you to recognize problems that are more common among the elderly (such as dementia) and also help you to educate your patients about these issues.
YOU'LL HAVE TO MAKE AN EXTRA EFFORT, BUT IT WILL PAY OFF
You may have to make an extra effort because medical education has not yet adapted to the realities of what the world will be like when today's medical students are physicians. As of 1998, the American Association of Medical Colleges shows that only 14 of 126 medical schools require students to take a course in geriatrics, and only 85 offer elective courses. Only 3% of all graduating medical school students have actually taken an elective in geriatrics.
Example, on the 1998 ABIM (American Board of Internal Medicine) Internal Medicine Certifying Exam ten percent of the questions focused on geriatrics-- tied with critical care medicine for the greatest portion of the exam.
Why Should I Consider Becoming a Geriatrician?
GERIATRICS CARE MATTERS
The vast majority of outcome studies show that good geriatric care results in increased quality of life, lower morbidity, and lower mortality versus traditional medical care.
THERE IS A HUGE DEMAND
A 1996 Alliance for Aging Research study shows that there is a shortage of more than 13,000 doctors who are needed to care for geriatric patients. By 2030, the estimate is that 33,000 geriatricians will be needed to care for the elderly. There are currently only 8,800 who are certified in geriatrics. Because of retirement and the 1994 change in requirements for certification in geriatrics, this number is expected to drop. This demand means that you'll have your pick of opportunities in geriatrics.
IT IS EMOTIONALLY FULFILLING
Geriatricians have more satisfying interactions with patients. In the managed care setting, many physicians complain about not having enough time with patients. However, being a geriatrician means that you have more time to see patients because managed care expects you to need the extra time. Also, many geriatricians make home visits and enjoy the unique interaction they allow. Contrary to popular opinion, most geriatricians do not treat only people who are very near death. It is not uncommon to see patients for many years, even decades. This allows for an incredible patient-physician relationship to develop.
IT IS INTELLECTUALLY STIMULATING
Geriatrics is a very intellectually stimulating specialty. Almost every older patient that you take care of will have several concurrent problems. A "simple" case is rare. This means that you, as their doctor, must know not only how to treat and manage each of these problems, but also the interactions amongst them.
THE TEAM APPROACH
A multi-disciplinary, team-based approach allows you to look at all aspects of the patient: As a geriatrician, you will often serve as a team leader, working closely with nurses, social workers, psychologists, pharmacists, physical therapists, occupational therapists, speech therapists, and others. This means that you and the team can do a lot for the "whole" patient rather than focusing only on the medical problem.
THE WORLD OF GERIATRICS IS WIDE-OPEN
Opportunities abound-- the field of geriatrics is wide-open. You can focus on one area (i.e. rehabilitation), or pursue careers in academics, research, health care administration, or even the pharmaceutical industry.