What exactly is a geriatrician? I’m 70 years old—should I be seeing one?
A geriatrician is a primary care physician—typically a family physician or internist—whose practice is dedicated to older patients, often those who are at least 65 years old. But there’s no set age for seeing a geriatrician. Geriatricians work in clinics, hospitals, home settings, and long-term care facilities.
Curiously, while the terminology for many medical specialties like neurology and cardiology has existed for centuries, the field of geriatrics wasn’t given a name until the 20th century, and formal competency requirements weren’t developed until the 21st century. In fact, it was an Austrian-American doctor, Ignatz Leo Nascher, who coined the term geriatrics (from geras, meaning old age, and iatrikos, relating to the physician) “to emphasize the necessity of considering senility and its disease apart from maturity and to assign it a separate place in medicine,” as he explained in the New York Medical Journal in 1909.
A big deciding factor in whether to see a geriatrician is your health status, regardless of your age. If, at age 70, you are healthy, exercise regularly, and have, for example, just one uncomplicated health condition such as high cholesterol, you don’t necessarily need a geriatrician. But if you have several health conditions (such as chronic kidney disease, diabetes, and heart disease) and are taking a variety of medications, it could be a good idea to have a geriatrician overseeing your care. After all, it can become complicated managing multiple conditions and treatments, where a drug for one illness can negatively impact another condition or interact with other medications, or if you are having side effects from these drugs.
Geriatricians also help manage the many other complex health conditions that typically affect older people, including balance problems, arthritis, osteoporosis, memory difficulties, and incontinence. To provide optimal care, they may work with other healthcare professionals, including nurses, physical and occupational therapists, social workers, and pharmacists. In addition, geriatricians help guide older patients who are deciding on end-of-life care.
It’s estimated that about 30 percent of older people (65 and older) would benefit from the care of a geriatrician. Unfortunately, the supply of these specialists was just barely meeting demand in 2018 in both metro and nonmetro areas, with the number of practitioners on the decline—and projected to continue declining—through 2030, as demand is projected to continue rising. One suggestion to alleviate this problem would involve more robust teaching of aspiring doctors—beginning in medical school through residency training and beyond—about the principles of caring for seniors.
How effective are geriatricians? A study in Gerontology & Geriatric Medicine in 2019 examined the medical records of 1,335 older people (65 and up) who were seen in the emergency room after suffering a trauma, mostly falls, and admitted to the hospital. The investigators found that if a geriatrician was consulted early on, there was a significant decrease in the number of days that patients remained hospitalized, compared with when a geriatrician was not consulted. There was also a greater likelihood that patients were safely discharged to their home rather than to a nursing facility if they had a geriatric consult early in their hospital stay.
Another study, in the Journal of Clinical Medicine in 2022, followed 150 people, 75 and older, who had been hospitalized because of heart failure and then, after discharge, were seen either by a cardiologist (control group) or by a cardiologist plus a geriatrician (intervention group) over the next year. This randomized controlled trial found that including the geriatrician in follow-up care was better at reducing rehospitalization for any cause, compared with seeing a cardiologist alone.
What does it take to become a geriatrician? To be certified by the American Board of Medical Specialties, the physician, who is typically licensed in family or internal medicine, must pass a board exam after completing a subspecialty fellowship lasting one or two years. Fellowship programs in geriatric medicine include clinical training in such areas as rehabilitation, neurology, geriatric psychiatry, and palliative care.
BOTTOM LINE: If you are older and have a number of health conditions or are taking multiple medications, you may want to discuss with your primary care physician whether you could benefit from seeing a geriatrician. Your doctor may be able to recommend a specific geriatrician, or you can find one on the website of the American Geriatrics Society.
