Friday, July 11, 2014

Do we need more "old people" doctors?

Geriatricians--these are medical doctors with advanced training in taking care of people over 65--with their multiple ailments, multiple meds, rambling descriptions, many specialists.

By 2030, according to a story by Barbara Sadick (WSJ, June 9, 2014), one in five Americans will be over 65. That's 70 million!

Yet, last year, there were 797 fellowships in cardiovascular and 125 in geriatrics. The latter is not growing in popularity among docs.

Office visits for older people run longer as a rule, they docs only get paid fee for service (Medicare). Often there are no cures--just ways to make people more comfortable.

Still, four heavyweight med schools joined forces in 2004 to provided more geriatric training. They like a holistic approach--physical, psychological, economic, social, nutritional.

When my mother was alive, she had a Medicare HMO that had no--ZERO--geriatricians on the roster. A plan for old people with no doctors trained in old people.

But do we need them to be? Maybe a little more patience, a constant monitoring of the nutty overprescribing of meds, and minimization of the running around and getting tests routine.

Now, I am old, too--and am often irked by doctors rushing me, cutting me off, patronizing me, and calling me "youngster." That is the worst.

I have pretty good luck asking them what would they advise if I were their mother. Try it.

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