A Geriatrician is an Internal Medicine physician or Family Practice physician with extensive training in the care of older adults. A Geriatrician is particularly interested in older adults and the impact of illness on the quality of life. Most Geriatricians prefer to work with a team of health care professionals that may include social workers, advanced practice nurses or physical therapists to develop a comprehensive treatment plan for an older person. This is called interdisciplinary medicine.
Older adults are a diverse population and no two individuals age alike. Most Geriatricians usually see patients who are 75 years of age or older. There are two types of Geriatric Practices.
- Geriatric Consultant: A Geriatric evaluation is based on the understanding that illnesses may appear differently in older adults, as older people are more likely to have multiple health problems. Patients are usually referred by their Primary Care Physician (PCP) or by self-referral for specific reasons related to a decline in overall health. Typical reasons for referral include: evaluation of memory loss, urinary incontinence, loss in functional abilities or management of multiple medications. Individuals are usually seen once or twice and are then referred back to their primary health care provider with a treatment plan. This process of evaluation is called a Geriatric Assessment.
- Geriatric Primary Care: In these practices the Geriatrician is also the primary health care provider. Typically, in this practice practice adults of all ages are seen.
Training and Credentials
In Virginia, all physicians must become licensed with the Department of Health Professions-Board of Medicine in order to practice medicine. A licensed physician must renew his or her license every two years.
Preparing to Visit a Geriatrician
People are referred to a Geriatrician because of some form of impairment or a specific health issue, and as a result are usually accompanied by a caregiver. For example, an older individual with progressive memory loss over the past six month might visit a Geriatrician in order to evaluate the type and cause of memory loss. No matter what the concern, on an initial visit the patient and caregiver should remember to:
- Set realistic goals and expectations,
- Prepare a list of questions,
- Be prepared to discuss fully the patient's medical, environmental and emotional history,
- Use your time well, the initial evaluation with a Geriatrician in private practice may last for only 50 minutes,
- Ask questions that are pertinent,
And also remember that:
- A complete evaluation will take more than one visit,
- The Geriatrician, usually a patient advocate, is there to listen and teach as well as to make recommendations and a diagnosis.
Cost & Coverage
A thorough Geriatric Assessment is very involved and usually costs more than a routine office visit. If there are other medical diagnoses, Medicare Part B or Part C will usually cover 80% of the bill. You are responsible for the remaining 20% of the approved amount of the bill after the annual deductible has been satisfied -- Medicare Supplemental Policies (Medigap) will usually cover this amount. If the physician accepts Medicare assignment, the office will accept the Medicare predetermined fees. Most Geriatricians accept assignment. However, if the doctor does not accept Medicare assignment the difference may have to be paid out of pocket.
- Since Geriatricians routinely see frail elderly adults who depend on caregivers, they understand the role of caregivers in their patients' health. The Geriatrician or the Geriatric staff can usually provide resources on how to manage caregiver stress.
- Before an initial visit to a Geriatrician, you and your caregiver may be asked to complete several forms and questionnaires about your health and medical history, current medications or the caregiver's concerns. Take the time to complete all paperwork fully with as much detail as possible. These documents will help the Geriatrician better understand your overall condition.