Portland, Oregon

Portland, Oregon

Tuesday, February 2, 2016

Scarcity of Geriatricians

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.


15 comments:

  1. I couldn't agree with you more! My GP treats me as if I am a two year old. She practically pats my little gray head. Oh, I shouldn't get started ...

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    1. Exactly the reason Bob changed doctors. We were just fortunate to have access to a geriatrician.

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  2. Wow! I'd never heard of a geriatrician. Bob's sounds like a truly caring doctor who is sensitive to and respectful of the needs of older adults. What a lovely way she handled Bob's grieving after his twin's death. I like the phrase "A tincture of time" and believe in its value. Love this post!

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    1. Bob's geriatrician seems to understand the medical world cannot make people live healthy lives to the end, but can make their lives much more comfortable to the end.

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  3. This is the first I have heard of such a wonder. Think I will Google to see if there are any in this area. Sounds wonderful. Of course it sounds like you have found a special lady.

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    1. We think we've found a special lady. I don't think she views the death of one of her patients as a failure on her part but rather is confident enough in herself she celebrates she was able to give that patient good care and comfort to the end of their life. So many doctors today become defensive, almost irritated, a patient would dare to die.

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  4. Hi Linda, Thanks for visiting my blog. I am so glad you like your husband's doctor. I wish I could get a dr. We had ours leave and a new came and took her place and now she has gone too. Where are the great G.P.'s??? Wishing you and your husband well. xoxo,Susie

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    1. If you read back a few posts on this blog I wrote about finding a new doctor. It's sometimes difficult.

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  5. I couldn't find any listing for geriatric doctors at Group Health. But so far my family practice doctor has been good at listening to me and getting the treatment I need.

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    1. No doubt much depends on the doctor. In our case the doctor we were both using was perfect for me but not for Bob. I call her The General. Everything is black and white with her. She goes strictly by the forms on her computer screen. Check, check, check, and she's through and you're out of there. I love it. It was a disaster for Bob, thus the change to the geriatrician.

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  6. How very interesting! Louis Dean is 80 but thankfully he has a wonderful doctor who seems very knowledgeable about treating her older patients! Her father was Louis Dean's Doctor until he retired and now his daughter has his practice!
    Mother has an older Doctor and often refers to her age (89) as 'this level of maturity.' I love that!
    The quads are napping at my feet and I am enjoying catching up on your posts and the links you provided! Thank you!

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  7. I know you have been a busy lady but I'm glad you've stopped by. Sounds like you're in good shape with your doctors. Doctors are incredibly important the older we get. Looking forward you your blog about the quads visit today.

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  8. G'ma had a great geriatrician,too. He took time, knee to knee, to discuss what she considered Quality of Life. We left the office with all 3 of us on the same page, which made ongoing decisions much easier. So glad you have a good one in your life, too.
    a/b

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  9. You are so right. Being on the same page is so important but many doctors don't get that. I think many are hesitant to talk about end of life issues.

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  10. I've seen that my clinic has geriatric doctors. The clinic I go to is part of a large group of physicians. I don't actually know all they offer but I chose them because I needed an endocrinologist. She is working wonders with my diabetes. I also feel good knowing that if I ever need a specialist they will have one for me to see.

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