How to Find a Geriatrician for Long-Term Care - dummies

How to Find a Geriatrician for Long-Term Care

By Carol Levine

Copyright © 2014 AARP. All rights reserved.

If, for whatever reason, you are looking for a new doctor in your long-term care planning, try finding a qualified geriatrician. But it’s not as easy as it sounds, because there’s a shortage of geriatricians. Some established geriatricians are not taking new patients, or they may require a long wait for an initial visit. Many geriatricians see patients only part of their time because they are involved in training programs.

The special medical needs of older adults

The good news is that Americans are living longer, and many older adults are in good or excellent health. However, with increased longevity comes the likelihood of medical conditions that require ongoing attention.

Many factors contribute to length of life, but in general women live longer than men. If you are a man who celebrated your 65th birthday in 2003, you can expect to live to the age of 81.8; a woman of the same age can expect to live to 84.8. Of course, these ages are averages, and everyone knows 90- and 100-year-old men who are doing fine and women who have died at much younger ages.

Increased longevity, has increased the burden of chronic disease. In earlier days people died from acute (rapid onset) conditions like pneumonia, bacterial infections, or accidents. Although these causes of death still exist, the more common conditions are chronic; that is, they last a long time and can be treated but typically cannot be cured.

Here are some suggestions for finding a geriatrician:

  • Check online: Members of the American Geriatrics Society (geriatricians, geriatric nurse practitioners, and geriatric physician assistants) who wish to participate in its referral program are listed. The Society does not endorse individual providers, but all the physicians listed are either Board Certified in Geriatric Medicine (internists) or have a Certificate of Added Qualifications in Geriatric Medicine (family physicians).

    Some commercial websites also offer to help you find a geriatrician. These lists can be useful but they are not comprehensive, and the doctors have probably paid to be listed.

  • Contact a hospital: Contact a hospital or academic medical center in your area. Its “Find a Physician” lists provide names and qualifications.

  • Use Medicare resources: If you or your parent is a member of a Medicare Advantage plan, look at the list of providers in the plan to find geriatricians.

  • Ask around: Use the old-fashioned method of asking friends and family. Ask specific questions about how efficiently the office is run, whether the doctor has good communication skills with older adults, whether he or she has emergency back-up if needed, and any other questions that may apply to you or your parent.

    Is the office easily accessible, even for a wheelchair? Are the staff pleasant and responsive to older people? If you have to be admitted to a hospital, which one will it be? Does the doctor make hospital and home visits?

The shortage of geriatric specialists

According to the American Geriatric Society, currently about 7,500 certified geriatricians are working in the U.S. Given projections about the increase in the 65-and-older population, approximately 17,000 geriatricians are needed to take care of 12 million people (30 percent of the population over 65).

In addition, there are only 1,600 geriatric psychiatrists, and less than 1 percent of registered nurses, pharmacists, and physician assistants and 2.6 percent of advanced practice nurses are certified in geriatrics. The situation is no better in other professionals that routinely see older adults; about 3 percent of psychologists devote the majority of their practice to older adults, and 4 percent of social workers specialize in geriatrics.

The future does not look promising, as very few medical school graduates are pursuing advanced training in geriatrics. The lack of interest may be because geriatrics is not a high-income specialty, work schedules are less predictable than in other specialties, and working with older people may not be considered as stimulating or challenging as other fields.

Yet older adults account for a disproportionate share of all health care services, from 26 percent of all physician office visits and 35 percent of all hospital stays to 90 percent of all nursing home care.