This week Ronni Bennett wrote about The Scarcity of Geriatricians on the Time Goes By blog. After reading her post I feel grateful we were able to get Bob under the care of a geriatrician. Apparently they are not easy to find and their practices are full if you do find one. She refers to an interesting article in the New York Times.
I won't cover ground here that she covered in her blog but I encourage you to read her post.
What I want to talk about here is what we have experienced with care under a geriatrician as opposed to a regular family practice physician. A geriatrician is a physician already certified in internal or family medicine who has completed additional training in the care of older adults.
Bob's geriatrician is a woman from Slovenia so there is perhaps some cultural influence in the care she gives. Here are just a few things I have noticed that are different about her care.
1) She is not in a hurry. You get as much of her time as you need. That said, you pay for this by sometimes waiting a while to see her. She's often not on time but you know when she gets to you she will give you her full attention.
2) She has a different approach to medications. Medicines sometimes act differently in older people. She talks about studies of senior adults taking a drug, not studies of the general population taking it.
3) There is a psychological difference in how she approaches the patient. More awareness of what may be going on mentally in an older patient.
4) She believes in what she calls "a tincture of time." She uses that phrase often. She believes "a tincture of time" is often good medicine. That may be cultural but I use that term often myself. I also believe "a tincture of time" takes care of a lot of things.
5) She believes in keeping it simple, no more than is necessary. Too many medications and you often get additional problems.
6) She speaks in a loud clear voice, mindful older people often have hearing issues.
7) Her nurse calls to follow up. Once Bob was in the emergency room and we got a call from her office the next day when the ER report reached her office.
8) The first time Bob saw her was shortly after the death of his twin. She took both Bob's hands in hers and told him she was sorry about him losing his brother and knew he was grieving. Said there was not a pill she could give him for being sad but he would begin feeling better.
Keep in mind she is in our community hospital owned clinic, not in private practice. Geriatricians are a good thing, we need more of them.