When You Need a Geriatrics Doctor
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The population of older Americans is exploding, but there’s a shortage of the very doctors trained specifically to treat them, according to the American Geriatrics Society.
Geriatricians are board-certified physicians (usually family doctors or internists) with special training and certification in the health needs of older people.
“Not every older adult needs a geriatrician—or will be able to find one,” says Annette Medina-Walpole, M.D., chief of the division of geriatrics and aging and professor of medicine at the University of Rochester Medical Center.
But the specialists can be critical, she notes, for “people whose health conditions are causing impairment or frailty—and whose family and friends feel stressed out or overwhelmed by complicated treatment plans or the need to consult multiple doctors for multiple health conditions.”
Many Patients, Few Doctors
There are currently 7,293 certified geriatricians in the U.S. To adequately treat all the patients who would benefit most from seeing them, it would take about 20,000 of them, the American Geriatrics Society has estimated.
Yet few medical students are choosing this specialty—and spots in training programs go unfilled as young doctors choose better-paid fields. In 2013, just 96 residents in internal or family medicine entered a fellowship program to specialize in geriatric medicine.
And it’s not just doctors: Fewer than 5 percent of nurses, physician assistants, pharmacists, psychologists, and social workers have training in the unique needs of older adults. Programs across the U.S. are working to fill the gap by training more healthcare providers to treat these needs.
All of this means it can be hard to find a geriatrician—but taking the effort to look can be worth it.
Who Needs a Geriatrician?
About 30 percent of older adults need one of these specialists, according to the American Geriatrics Society.
Someone older than 75 who has several health conditions, takes a number of medications, and may also have memory loss or dementia can benefit the most from seeing a geriatrician.
Geriatricians are also specially trained to look for and treat frailty: general physiological decline that often (but not always) comes with age, and can make patients more vulnerable to a litany of additional health problems.
One Dutch study found that geriatricians are more likely than general practitioners to look for early signs of frailty (such as unintentional weight loss, fatigue, and reduced strength)—and more likely to address it effectively, according to another study by researchers in Spain.
The specialists also routinely take a close look at the medications people take, whether they need to be adjusted, and whether age-related changes in liver and kidney function have affected how well they’re working, Medina-Walpole says.
And they have particular expertise in evaluating and helping people cope with late-in-life health issues that can be overlooked or challenging to treat—frailty as well as falls, incontinence, dementia, and delirium.
Keeping an eye out for these issues can make a big difference, research has found.
In a 2012 review of 50 geriatric-care studies, researchers from the Department of Veterans Affairs found that older adults who got outpatient care from a geriatrician were less likely to end up in the hospital—and their overall healthcare costs were lower. (A key focus of geriatricians is helping their patients retain autonomy.) Plus those with a geriatrician as their primary care doctor were less likely to be taking risky medications.
You can look for a geriatrician practicing near you by using this online locator service, provided by the Health in Aging Foundation and the American Geriatrics Society.
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