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The importance of a geriatrician

Posted May 05, 2016 by Maryjo L. Cleveland, MD

I am frequently asked, “What is a geriatrician, anyway?” and, “Doesn’t my family doctor take care of older adults?” These are great questions!

The answer to the first is that a geriatrician is either an internist or family physician that chooses to do an extra year or two of fellowship training to learn more about caring for elderly patients. The fellowship is very broad and teaches to these areas:

  • Medical issues (what are symptoms of a heart attack in an older adult?)
  • Geriatric specific issues (is this Alzheimer’s disease?)
  • Physical issues (why is this patient falling?)
  • Pharmacy issues (is this medicine safe in an older kidney?)
  • Social issues (would meals on wheels help this patient?)
  • Financial issues (what community programs do they qualify for to help keep them in their home?)
  • Legal issues (who is the best option to be the power of attorney for healthcare?)
  • Advanced planning issues (have they discussed end of life decisions?)

As you can see, a geriatrician becomes a master of a very wide variety of topics!

The answer to the second question is that, yes, your family doctor takes care of older adults, but sometimes, the patient becomes so frail or complicated that a referral to someone who has the specialized training listed above is helpful.

In addition, the way primary care doctors are reimbursed by Medicare generally leads to visits that are approximately 15 minutes long. There is almost no way to cover a frail, older adult’s myriad of problems in that 15 minutes. The geriatrician has additional time and resources (usually a social worker) to help manage these problems.

Geriatricians are a scarce resource. There are only 7,500 of us in the entire country! With a senior population of over 40 million, there is no way that geriatricians can be the providers of primary care to the senior population. So, at Summa we work in a consultative model to come along side the primary care physician and assist with the frailest patients.

This model of care is common. For instance, most patients with congestive heart failure are managed by their primary care physician, but some percentage end up seeing a cardiologist because they bring specialized knowledge and skill to the situation. They work with the primary care physician to help manage the complicated problem of congestive heart failure. Likewise, a geriatrician does not need to take over the care of the patient to be able to lend his/her knowledge and skills to complicated problems related to aging, whether it be at the hospital, a doctor’s office, a skilled nursing facility or at a patient’s home.

Summa’s Center for Senior Health is nationally-acclaimed for its model of care for seniors, offering an integrated approach that enhances quality of care and access to services. Call (330) 375-4100 for more information, or visit

Maryjo L. Cleveland, MD
Chief, Division of Geriatric Medicine


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