Quote:
Originally Posted by Villages PL
Here's some information that might help with the "geriatric question". I called ask-a-nurse at The Village's Hospital this morning. I asked, "what's the difference between a doctor who has studied Internal Medicine and a geriatrician?"
This is the answer she gave:
Internal Medicine covers general medicine for adults (14 and older).
Geriatricians, in addition to having studied internal medicine, have special knowledge and training for the diseases and disorders of the elderly.
I would add this: It seems logical that a Geriatrician would provide better overall care if they have a better understanding of the elderly. And a better understanding would likely result in a different drug prescription.
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PL, I'm not being confrontational in saying this, but just trying to raise awareness as you are. By insisting that these
primary-care doctors be geriatricians, you are insisting that the primary-care doctor be a
sub-specialist.
One of the problems with that is with all the "overhaul" and upheaval in healthcare finance right now, pretty much everybody knows that the goal is to put more money into primary care,
to prevent the over-use of more costly specialist and especially sub-specialist care and treatment.
Yes, geriatricians are needed for elderly people who have chronic disease and multiple complex organ-system failures interacting and complicating each other. But people like you who take care of yourself (and there are many more like you than you appear to think) who don't have complex chronic medical problems to manage/treat,
do not need a sub-specialist (geriatrician) for their primary-care needs.
Even more important in this picture: There is already an existing shortage of internists in this country in proportion of the population at, and reaching, age 65+. So if there is a shortage of internists, there is a corresponding shortage of geriatricians, because they are sub-specialists of internal medicine.
Knowing that it's going to be hard to find enough
motivated and available internists to staff all the TV clinics, I'd say it's even harder to find as many geriatricians as you see as needed.
And then there is the issue of the focus by Medicare/medicaid to shift and bolster payments
toward primary care for prevention purposes, and away from specialists and sub specialists.
And about your aunt having 6 prescriptions and trusting her doctor who's a "good" doctor. I don't know about her, but with many people, those 6 prescriptions could have come from 5 other specialists who were not the lady's primary doctor. That is one more reason the shift in focus of healthcare funding right now is toward the
primary-care generalist who oversees and should have to approve referrals to specialists.....to both lower healthcare costs, and assure accurate, efficient treatment.
These are points to think about....I'm not arguing.