- Outside of strong medical knowledge, the most important attribute to seek in a doctor for older adults is strong attention to detail
- As we age, we need doctors who look beyond the problems that brought someone into their office and get “in the weeds” about what might be the matter
- Common red flags are talking down to or ignoring the patient, interrupting, or being dismissive of complaints
- If any of these things occur, it might be time to look for a new physician
Signs You’ve Chosen the Right Physician
A critical piece of comprehensive care for older adults is partnering with a doctor you have a strong relationship with. Beyond foundational capabilities like empathy, exemplary examination skills, and strong diagnostic abilities, there are a handful of qualities to look for when choosing a doctor that understands healthy aging. Here are signs you’ve found the right provider — as well as some that indicate you need to keep looking.
They Sweat the Small Stuff
At any age, the baseline for a good physician is board certification paired with strong medical competence and knowledge. Assuming those boxes are checked, the most important attribute to seek in a doctor for older adults is exceptionally strong attention to detail.
Why? Geriatric medicine is nuanced work. As we get older, life-altering problems can arise from neglected medical and social issues, some of which may seem trivial when they come up. Finding a thorough, detail-oriented physician can prevent one of the more significant problems in geriatric medicine — a missed diagnosis.
>> READ: Should you switch to a geriatrician?
Avoiding a Missed Diagnosis
A sizable body of scientific research shows that many conditions common in older adults (e.g., depression, memory loss, mobility problems) aren’t detected by their physicians. This is true even when they have long-standing relationships with them.
With physicians seeing an average of 20 patients per day, managed care pressures doctors to laser-focus on the issue that brought the patient into their office. Physicians are often tight on time and may not ask about problems that haven’t been proactively brought up. Patients may also actively conceal conditions from their doctor, or a well-meaning adult child or spouse who accompanied them to the appointment might do the talking.
As we age, we need doctors who consistently look beyond the problems that brought someone into their office and get very “in the weeds” about what might be the matter. For example, a rash could be from an infection, or it may be from an antibiotic the dentist prescribed. Stomach pain could be indigestion, life-threatening diverticulitis, or depression. A patient may be falling repeatedly from cataracts, medications, arthritis, or a combination of all three. Thoroughness and attention to detail are needed to ensure nothing is missed and the best course of action is identified.
They Unite Fractured Care
The older we get, the more doctors we see — particularly in our sub-specialty-oriented culture. The result is uncoordinated medical care that can be dangerous for an aging adult.
There are many risks of fractured care. One is accidentally taking too much medication, or taking medications that interact negatively with each other. This can happen when a specialist doesn’t know about prescriptions from other doctors.
Another risk is medical information not making its way from your primary care physician to a specialist and vice versa. When you traverse different doctors and medical systems, critical information can fall through the tracks. Tools like our Medical 101 Sheet can help you take control of your information and stay organized.
But there’s nothing more important than having a single captain of the ship — a primary care physician you trust — who can look at everything holistically. A good doctor can be your first call on issues big and small, steering you towards the correct next step.
They Provide the Right Doctor-Patient Fit
Doctor-patient fit refers to individualized expectations and preferences regarding medical care. Assuming a high baseline competency in any doctor you choose, different people will want different things from their physicians. It’s critical to know what’s important to you or your loved one.
Some people care most about finding a doctor with excellent technical prowess but don’t need amazing interpersonal skills. Some want big communicators: doctors who can sit and speak with them about all possibilities. Others like the opposite: doctors who prioritize brevity and tell you only what you need to know. Understanding these preferences is an essential step in finding the right doctor.
Red Flags That Signal You Need to Keep Searching
Knowing what to look for in a physician is essential; just as important is recognizing the signs that something isn’t quite right. If you notice any of the following in your or a loved one’s doctor, it may be time to find a new physician.
- Talking down: As you get older, you may notice you or your loved one being addressed in a way that “babies'' the patient, either in content or tone. While some patients may not find this problematic, it's concerning, particularly in a new doctor-patient relationship.
- Ignoring the patient: While it can be appropriate, supportive, and helpful to accompany a loved one to the doctor, the physician must address them primarily and directly. Some doctors demonstrate a proclivity to talk about older patients as if they’re too impaired to understand, or not in the room at all. Eye contact and discourse should be primarily directed at the patient.
- Interrupting: This happens with patients of all ages; evidence suggests most patients get interrupted and/or waylaid within the first minute of articulating their “chief complaint” to the doctor. Patients are especially at risk for this problem if their thoughts are not well organized heading into the appointment.
- Dismissive of complaints: As we age, physicians tend to minimize the problems described by patients, attributing them to “just getting old.” This is an ageist and potentially dangerous error. While there are diseases that become more common as people age, attributing all symptoms to getting older — being tired, having aches and pains, experiencing memory loss — could mean missing a significant and treatable condition.
- Quick to refer, test, or prescribe: Another way of dealing with patients who “take up too much time” is to write a prescription or send them for a test or to another doctor. Patients love prescriptions; many feel like they haven’t been to the doctor unless they leave with one. The problem is “more” is often “less” as we age. While referring and prescribing can be the appropriate course of action, it needs to come after the patient feels heard and thoroughly examined.
Where to Look if You Need a New Physician
If you’re looking to find a new “aging friendly” physician, one starting place is to look for a geriatrician — a specialist who focuses on older adults.
To find a geriatrician, start with nearby medical schools or university hospitals and see if they have a department of geriatric medicine. If they don’t, you can pivot to their department of internal medicine and look to find an internist who has many of the qualities described above.
Another good resource is the geriatrician finder from HealthinAging.org.
It’s also a good idea to ask friends and family if they recommend their physician. Don’t be afraid to have consultations with a handful of doctors before settling on one.
A more boutique, concierge doctor practice could also be the right solution. When practiced well, concierge medicine and geriatric medicine share similarities, like a strong attention to details. Read our guide on concierge medicine here.
