WHAT IS A GERIATRICIAN?

by Robert S. Stall MD

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From Webster's Third New International Dictionary:

Main Entry: geriatrics

: a branch of medicine that deals with the problems and diseases of old age and aging people —  compare GERONTOLOGY

Main Entry: geriatrician

 : a specialist in geriatrics

Main Entry: gerontology

 : a scientific study of the phenomena of aging and of the problems of the aged —  compare GERIATRICS

The most appropriate term for a physician who specializes in the care of older adults is geriatrician, not gerontologist.  A gerontologist is generally a non-physician, though physicians who focus on aging research can also be considered gerontologists.

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Just as pediatricians are physicians who specialize in the care of children,
geriatricians are physicians who specialize in the care of older adults.

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There are different levels of training among geriatricians:

  1. No Special Training

Many physicians have practices that are largely comprised of older adults.  By virtue of their day-to-day experience and personal continuing education efforts, they may attain above-average knowledge and skills in caring for elderly persons.  They may consider themselves geriatricians, though the term in usually reserved for physicians who have specific training and certification in geriatric medicine (see 2. and 3.).

  1. Added Qualifications in Geriatric Medicine

The American Board of Internal Medicine and American Board of Family Practice offer a certificate of Added Qualifications in Geriatric Medicine to those Internists and Family Practitioners who can pass a standardized exam that has questions dealing solely with geriatric care issues.

  1. Fellowship Training

The highest level of qualification is when a physician spends extra time studying geriatric medicine in a formal training program.  These programs, called Geriatric Fellowships, generally range from one to three years of study after completion of a formal residency program (usually Internal Medicine or Family Practice).  The Fellowship Program usually has both clinical and research components incorporated into the curriculum.  Most Fellowship Trained Geriatricians go on to take the exam that also gives them a certificate of Added Qualifications in Geriatric Medicine.

How old do you have to be to benefit from the skills of a geriatrician?  It depends.

Geriatricians are expert in dealing with multiple medical problems and chronic illness.  Geriatricians focus on optimizing quality of life and functional ability for their patients rather than seeking definitive cures.

Geriatricians use a holistic approach to address the physical, psychological and social problems surrounding the patient and family.  A geriatrician works closely with other health care professionals and organizations, including other physicians, therapists, home care agencies, pain clinics and support groups, to meet the specific needs of each patient.  A geriatrician considers the patient and family as key members of the health care team, and expects them to contribute to all decisions that need to be made.

Ailments that a geriatrician will address include Alzheimer’s disease (and other dementias), arthritis, chronic heart & lung disease, general decline, impaired overall function, incontinence, osteoporosis, Parkinson’s disease, sensory problems (esp. vision and hearing) and stroke.

The geriatrician will also scrutinize the often-large number of medications older adults take to ensure that the medications are appropriate and are not causing serious adverse side effects.  Many times, medications can be adjusted with significant improvement in the well being of the patient.  Pain and mood disorders such as depression are common in older adults – the geriatrician checks for these as well. 

If you are in need of the kind of care just described, whether you’re 65 or 95,
a geriatrician might be just the person for you.

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Copyright 2003 Robert S. Stall MD / Stall Geriatrics

Copies or reprint permission may be requested in writing from:
Robert S. Stall MD
Stall Geriatrics
14 Heritage Road West
Williamsville, NY 14221