[Villages PL]

Originally Posted by ilovetv

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.

I suggested (at least) one geriatrician per clinic. I didn't think that was a lot to ask for, being that these clinics will primarily serve an elderly population. If a GP thinks that someone of an advanced age, with multiple chronic conditions, could benifit from seeing a geriatrician, what will he/she do? Send that person to Ocala? Or, have they already made up their minds to just completely ignore that specialty altogether? That destroys the concept of conveinience, which was part of the reason for having neighborhood clinics in the first place.

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.

Well, that's a good point. But I'm not suggesting the over-use of Geriatricians. Last time I checked, one would need to go to Ocala to find a Geriatrician. There were two listed in the Ocala (area) phone book. As far as I know, we have none in The Villages at this time.

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.

People who are healthy today may eventually need a geriatrician as they get older. But perhaps these clinics envision the sickest going into nursing homes? Maybe that's the plan: Health care for those who are well enough to come in for an office visit. But how about keeping them well enough so they don't have to go to a nursing home. That should be the goal.

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.

There is a shortage, but even so, there are 7,029 certified geriatricians in the U.S.. All we nee is 8.

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.

Geriatricians could serve as ofice managers in the clinics. As such they would get payed more. The average GP gets an annual salary of about $122,070. The starting salary for a geriatrician ranges from $96,880. to $145,320.

In addition to being an office manager the geriatrician could take care of those older patients who have multiple chronic conditions. In other words, they could perform as a GP with salary and bonus. I know this can be done.