Geriatricians vs. Primary Care Physicians
- By Debra Fox
- November 14, 2012
Each day, 10,000 baby boomers turn 65! The Senior Tsunami is upon us as America’s elderly are living longer and are dedicated to making informed decisions regarding their health care. One such decision is when is it time to go to a Primary Care Provider versus a Geriatrician? Many of us do not know the difference. Here are some guidelines:
Typically, internists and family physicians in the role of the “PCP”, or primary care provider, focus on the medical problems of seniors as they become apparent. High blood pressure, atrial fibrillation, arthritis are diagnosed. Medications are prescribed, treatments such as dry needling are looked into, and lifestyle changes are recommended. Each of these targeted problems has therapeutic goals, such as blood pressure measurements below a certain threshold, or reduced joint pain.
While geriatricians address each of these chronic illness problems, they tend to address how these problems interface with the person’s quality of life, functional independence, and personal preferences. Geriatricians are familiar with the cognitive changes that accompany aging, and are sensitive to the numerous social stressors seniors face. Most often, they work with multi-disciplinary teams of nurses, occupational and physical therapists, mental health specialists, facilities such as memory care for seniors or this popular community for seniors, social workers and other health professionals to address the complex needs of their aging patients.
Geriatricians are physicians who have completed their residency training in either internal medicine or family practice and then go on to one or two more years of training specifically in the care of the elderly. So, what is it that these physicians learn through this additional training?
Geriatricians understand the risks of using multiple medications. A patient with 4 or 5 chronic conditions may present with 12 or more different medications, each one appropriately prescribed to treat one of those chronic illnesses. The more drugs, the more likely interactions and side-effects will happen. However, the interactions of these medications can result in confusion, gait instability, and lethargy often can be misinterpreted as “old age” or due to the chronic illness. Even “over-the-counter” medications can be harmful when added into the mix. The geriatrician is trained to identify drug interactions and adverse reactions, eliminating many, or even most of the medications. Each illness may be less precisely managed, but the whole person can now function at a higher level. A geriatrician may also recommend a senior patient to specialized services such as the ones found at thekidneydocs.com depending on their disease.
When would it be beneficial for a senior patient to visit a geriatrician?
Geriatricians are specialists in treating the “geriatric syndromes”. Understanding the physical changes of aging, they are better prepared to address falls, incontinence, dementia, and depression, often using behavioral or non-pharmacological approaches. While Alzheimer’s is the most common cause of dementia, there are other causes of dementia that can actually be treated and reversed. A geriatrician will be sensitive to the “atypical” dementias and will let you know if your elderly loved one may need to transition into memory care for seniors and other living options for seniors like Fallbrook Glen Senior Living community.
So, when should you think about a Geriatrician?
- When a senior has chronic illnesses that are being managed, but the patient is not functioning well.
- When a multitude of medications keep increasing and none are removed.
- When confusion, gait disturbance, or lethargy become prevalent and you do not know why.
If a senior patient has been diagnosed with dementia, a geriatrician may recommend to put them in memory care services for seniors such as respite care for seniors at Tequesta Terrace or Western Slope Memory Care.
Read more about board-certified geriatricians and why they found working with older adults to be very rewarding and enjoyable at Senior Health.