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-   -   Geriatric or Family Doc? (http://www.early-retirement.org/forums/f38/geriatric-or-family-doc-83201.html)

Tailgate 08-25-2016 08:11 AM

Geriatric or Family Doc?
 
DM, 87, good health, moving to independent living facility is in need of a new Dr.
Is there a significant advantage to seeking a GP with a Geriatric certification vs. a regular GP?

MichaelB 08-25-2016 08:18 AM

It made a difference (IMHO) with my mother's health care. Not so much a geriatric certification, but a physician with substantial geriatric experience and with a practice that was oriented toward older folks. I bet the independent living facility can provide some references.

Katiek 08-25-2016 09:36 AM

My mom recently switched to a Geriatric specialist from her general doctor, but the switch was due to a variety of reasons. She'd have been looking for a new doctor anyway, and didn't switch just to get a Geriatric specialist. I think the specialist has been good for my Mom, but I think there are a lot of factors that go into choosing the right doctor and the Geriatric specialty is only one of them. So while it's worth exploring, if another doctor is better suited for a variety of reason, I wouldn't feel limited.

CountryGal 08-25-2016 09:37 AM

I have two data points to go on. It absolutely makes a huge difference. They know far more about the common issues and they have communication skills to deal with older folks.

razztazz 08-25-2016 10:05 AM

Quote:

Originally Posted by CountryGal (Post 1772931)
I have two data points to go on. It absolutely makes a huge difference. They know far more about the common issues and they have communication skills to deal with older folks.

At about what age would you recommend a switch to a Geriatric certified doctor?

I will be 60 next year. That's sort of the historical and metaphysical line of demarcation for "geriatric" in most people's minds. Sort of like 21 means you're old enough to drink ( whether or not it's true) or Memorial Day is the start of Summer (which doesn't actually start for almost another month)

H2ODude 08-25-2016 01:38 PM

Alright Razztazz....off the board! I'll not have you determining that I'm 5 years past needing to be called GERIATRIC damn you!

razztazz 08-25-2016 01:50 PM

Quote:

Originally Posted by H2ODude (Post 1773027)
Alright Razztazz....off the board! I'll not have you determining that I'm 5 years past needing to be called GERIATRIC damn you!

Ha ha. I didn't say I personally believed the "60 is the New 40 while somehow still being the Old 60" paradigm. I believe I couched my presentation sufficiently to avoid incriminating myself.

That's sort of the historical

What is history but a fable, agreed upon? (Napoleon Boner)

and metaphysical line of demarcation for "geriatric"

Metaphysical? Schmancy way of saying: "It's only half real anyway."

in most people's minds.

Most people. That would be The Madness of Crowds

H2ODude 08-25-2016 02:32 PM

Well, harrumph then! Danged youngsters. :laugh:

As to the original topic, I thought actual geriatric specialists were scarce as the proverbial hens teeth. My main observation of geriatric care of MIL her last 8 years (passed at 89) was that she really didn't have decent general (or geriatric) care, but sure got tons of specialist and hospital care. DW was regularly taking her to neurologist, orthopedist, and then last few years it was almost monthly to ER, admittance to hospital, and rehab.

What was always missing IMHO was anyone paying attention to overall trajectory and care; that really fell to us. Yes, I guess some of the reports would make it to the GP but there was never what I would consider to be consultation (and coordination) of all this caregiving. Number of times meds were changed at hospital that previously were shown to cause problems (not allergies but problems). For all the money that was spent those last few years ($100's of thousands no question) it struck me that someone spending 30 minutes with her every few months honestly advising her of her likely outcomes might have made a big difference. Just one person's observation.

Brat 08-25-2016 03:00 PM

I know when I signed up for Kaiser Medicare Advantage Plan I noticed that they employed gerontologists but, as I recall, they cared for members in nursing facilities. IMHO any senior on a lot of meds should seek care from a physician with a geriatric speciality. The aged don't metabolize meds in the same way as other adults.

razztazz 08-25-2016 03:35 PM

Quote:

Originally Posted by H2ODude (Post 1773058)
Well, harrumph then! Danged youngsters. :laugh:

As to the original topic, I thought actual geriatric specialists were scarce as the proverbial hens teeth. My main observation of geriatric care of MIL her last 8 years (passed at 89) was that she really didn't have decent general (or geriatric) care, but sure got tons of specialist and hospital care. DW was regularly taking her to neurologist, orthopedist, and then last few years it was almost monthly to ER, admittance to hospital, and rehab.

What was always missing IMHO was anyone paying attention to overall trajectory and care; that really fell to us. Yes, I guess some of the reports would make it to the GP but there was never what I would consider to be consultation (and coordination) of all this caregiving. Number of times meds were changed at hospital that previously were shown to cause problems (not allergies but problems). For all the money that was spent those last few years ($100's of thousands no question) it struck me that someone spending 30 minutes with her every few months honestly advising her of her likely outcomes might have made a big difference. Just one person's observation.

Same with my mother. Dangerous drugs. Dangerous amounts of drugs. Different doctors all refusing to talk to one another. And don't ever suggest to Dr Smith that Dr Jones said not to do that. Doctors don't like hearing patients talk.

CountryGal 08-25-2016 07:31 PM

I think H20Dude and Brat hit it pretty good in terms of when to switch. My mom switched at 80 (after having a great doc in hospital) and Aunt at 92.

Consider that you probably would likely take a young child to a pediatrician, because they know kids well and thats all they deal with. I think the same applies here. You want a doctor used to treating the older body that may have been prescribed multiple medications and needs some extra time to understand all the issues going on with them.

Brat 08-25-2016 08:53 PM

Some kvetch about Kaiser but IMHO they manage care focusing on the quality of life and preventing problems. There is no heaven on earth but were I a frail elderly I would want a geriatrician overseeing my care.


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