When Should I Switch to a Geriatrician?

What Is a Geriatrician?

A geriatrician is a physician who specializes in providing care to older adults. Their objective is not only to keep patients healthy, but also to maximize function: a patient’s ability to complete daily tasks needed to live independently and enjoy life, even if they have several medical conditions.

Geriatrics is a subspecialty of internal medicine or family medicine. All geriatricians are internists — physicians who completed three years of internal medicine training after medical school, studying the complex inner workings of the body and the non-surgical treatment of diseases adults can acquire over their lifetime (like high blood pressure, diabetes, and arthritis). After training in internal medicine, most geriatricians spend an additional one or two years learning their craft.

Geriatricians are trained to look at many aspects of life outside of physical health, including mental health and one’s environment. They’re interested in everything from social dynamics to stress factors and living environment, all of which play a huge role in overall wellbeing as you age. They often correspond with a patient’s loved ones, like a spouse or adult children, to help find optimal solutions and preserve independence.

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How Old Does One Need to Be to See a Geriatrician?

There is no universal age to switch over to a geriatrician. While many think geriatricians exclusively see older patients, benefiting from a geriatrician is more about daily function than it is about age. Geriatric practices have 90-year-old patients who work daily, functioning like someone whose chronological age is 60. Then there are instances of 50-year-olds who are impaired by conditions like multiple sclerosis or a stroke and have the frailty of someone whose chronological age is much older. 

Essentially, there’s no age at which someone becomes “geriatric”; if they have chronic diseases and functional issues, a geriatrician could be a good fit. Additionally, a geriatrician can help older patients who are currently doing well but are looking to maintain or boost quality of life and avoid frailty.

It’s worth noting that if you or your loved one are happy with the internist or family medicine doctor you’ve seen for many years, you don’t have to switch to a geriatrician. Geriatricians are in short supply, which can make it challenging to find one. A doctor who already knows the patient and their history can be just as good of a fit, especially if they’re detail-oriented and thorough.

Geriatrician: Primary Care Physician or Specialist?

Is a geriatrician a primary care physician — the doctor you would see for your annual physical — or a specialist, like an orthopedist you would go to for a broken bone? 

The answer is both. Most geriatricians provide primary care to older adults and see them annually, or more frequently as the need arises. As a specialist, geriatricians are also available to help patients and their families with problems typically related to aging, like falls, memory loss, and living independently.

The key way a geriatrician differs from a standard primary care physician is their emphasis on function. While they’re trained extensively in everything an internist or family doctor does, like managing medications and reading EKGs, they’re particularly focused on how various medical issues interact with one another and how these interactions enable or disable a patient from living life in the way they want. As such, they bring varied expertise into their practice, including psychiatry, dentistry, and podiatry.

Going Beyond the Doctor’s Office

The main focus of traditional medicine is often sickness: examining an ailment that brought you into the doctor’s office. Geriatricians are interested and specialize in overall wellness and environment. This includes:

• Living arrangements, and if they’re set up appropriately to prevent falls
• Family and social circle, and level of engagement with others
• Stress and worries
• Diet and nutrition
• Daily routine and level of activity
• Medicare and insurance coverage
• Local social groups, support groups, and resources

As we age, medical issues and social problems become intertwined. Medical illness can cause social and psychological stress, and conversely, social problems can profoundly affect both the development of illness and the ability to weather it successfully. Additionally, our ability to endure problems as they arise can become inhibited. 

Because of this, concurrent medical and social issues begin to take a bigger toll and have a higher probability of impacting quality of life. Geriatricians look at all these pieces to understand the complete picture.