Have you ever felt like your provider didn’t understand your unique needs as an elder adult?  You may have heard of a geriatrician, but what makes them different from other primary care providers and how do you know what is the best fit for your needs? 

Types of Primary Care Providers

There are several types of primary care physicians or PCPs.  These practitioners are typically the ones you see for both your yearly wellness checks and when you’re feeling sick.  Most are classified based on the groups of people they care for and the education, specialized certifications, and training they receive.

  • Family Practitioners provide care for patients in any age group and are often seen by entire families so that everyone within a household can receive care from one provider.
  • Internists have special training in the prevention and treatment of adult diseases.
  • A Gynecologist specializes in the reproductive system health of women of all ages.
  • Geriatricians are uniquely trained to care for geriatric patients.  They specialize in treating social problems and complex medical conditions caused by aging.
  • Nurse Practitioners and Physician’s Assistants can also be primary care providers with specializations in many areas including but not limited to geriatrics, women’s health, and mental illness.

You may also have heard of Gerontologists.  Gerontologists are NOT medical doctors, but rather are professionals from various fields such as sociology, psychology, nursing, social work, and even dentistry who received certification in gerontology. 

A Geriatrician is a medical doctor (MD) or a doctor of osteopathic medicine (DO) who specializes in geriatric medicine and becomes board-certified in internal or family medicine.  Additionally, they must pass a geriatric medicine certification examination after completing a geriatric medicine fellowship at an accredited facility.

Considerations for Switching to a Geriatrician

Those who benefit most from receiving care from a geriatrician are individuals who suffer from severe functional impairment, have physical frailty, have geriatric-related syndromes, have been hospitalized, and/or have a highly complex medication regimen.  Geriatricians tend to treat patients based on their physiological age, not their chronological age, and aim to improve overall function.  A person’s physiological age is a measure of their health or deterioration.  At times, geriatricians may choose to prioritize treatment of specific conditions over others based on the medications being given and the resulting negative side effects.

Some of the most common syndromes that Geriatricians treat are:

  • Falls
  • Incontinence
  • Polypharmacy – or the use of multiple medications to treat multiple conditions
  • Depression and/or Anxiety
  • Cognitive Decline
  • Delirium
  • Frailty
  • Weight Loss
  • Caregiver Stress

Geriatricians may also provide care that focuses on wellness and preventative health and the management of chronic conditions.  They may schedule longer appointment times to allow for enough discussion time with their patients.  Geriatricians can help patients to avoid hospitalizations.  They are more versed in looking for potential signs of frailty and appetite loss and are also less likely to prescribe potentially risky medications. 

When choosing any primary care provider consider the following:

Access: 

  • Where are they located and is it convenient? 
  • What are their hours? 
  • How do they handle emergencies? 
  • Do they accept your insurance?

Training and Resources: 

  • What are their certifications?
  • What hospitals and medical centers are they affiliated with?
  • Do they coordinate with specialists, such as neurologists, cardiologists, and nephrologists, and specifically do they know which specialists are best at providing care to older adult patients? 
  • What is their communication style?  Do they use a patient portal, telehealth, phone, or in-person only?  Are you able and willing to communicate through the mediums that they typically use?
  • Will your provider have resources for not only you but also potential caregivers?

Philosophy:

  • Do your health goals align with your provider?  Goals may change as you age, so consider flexibility on both sides.

Finding a Geriatrician

Local Recommendations

Although there is an increasing demand for geriatricians as the number of seniors increases, an overall shortage of geriatricians available is prevalent across the country.  The Colorado Geriatric Provider Pipeline Program is a bill aimed at addressing the issue.  This bill will be on the ballot again in the 2023 legislative session of the Colorado General Assembly. 

The Denver metro area does currently have some great options.

Stride has a geriatrics team that provides comprehensive, person-centered care for patients 65 and older.  They are one of the first health systems in the country to implement age-friendly health care as part of the Age-Friendly Health Systems movement through the Institute of Healthcare Improvement. 

UCHealth Seniors Clinic has several Geriatric Medicine providers that specialize in the care of medically complex, adults 75 and older.  Their multidisciplinary team includes physicians, nurse practitioners, a psychologist, clinical pharmacists, a social worker, nurses, medical assistants, and patient advocacy representatives. They work closely with patients and their families to provide personalized care based on every patient’s needs.  There are three locations:

  • UC Health Outpatient Pavilion
  • UCH Lone Tree Clinic
  • The Kavod Retirement Community – open to Kavod residents as well as community members from the surrounding area.

Take Aways

  • It’s important to consider access to care, insurance, training, and resources as well as your care provider’s overall philosophy when choosing any provider.
  • The primary reason to see a geriatrician is NOT age.  Individuals with physical frailty, geriatric-related syndromes, and those taking multiple medications and managing multiple conditions benefit most from seeing a geriatrician.

Resources

Find Your Primary Care Provider | ClevelandClinic.org (2022). 

Specialists in Aging:  Do You Need a Geriatrician? | HopkinsMedicine.org (2022).

The Value of Geriatricians and Why We Need More of Them | AgingResearch.org (2016, March 22).

When It’s Time to See a Geriatrician | AARP.org (2019, Feb 11)

Which Patients Benefit the Most from a Geriatrician’s Care?  Consensus Among Directors of Geriatric Academic Programs | PubMed Central (2008, Oct).

By Gretchen Stevenson RN, BSN | September, 2022