Harvard Women's Health Watch

Ask the doctor: I'm 75. Do I need a geriatrician?

Q. My doctor, an internist, just retired, and my health plan is asking me to designate a new primary care physician. I'm 75. Would there be advantages to choosing a geriatrician as my new doctor?

A. First, a disclaimer: I am a geriatrician. So my short answer is, "Yes, of course!" But my reasoned, unbiased answer would be, "It depends." If you are a generally healthy 75-year-old woman, a family physician or internist will be able to take excellent care of you. Geriatricians are trained to care for older adults with complex illnesses and are expert in managing the care of people who are frail. Improving your ability to function, and the quality of your life, are the guiding principles of geriatric medicine. We are expert at managing complexity and uncertainty, working with families, and caring for people with serious illnesses who are approaching the end of life. A geriatrician would be a good choice if you have physical or cognitive impairment, if you take a lot of medications, or if your friends and family are involved in your medical care. For people who have several medical problems, we emphasize the role of patient and family preference in making medical decisions, with the patient's goals as our primary focus.

I have many people who come to my practice while they are still young (you aren't old until you are 85!) because they want to work with a doctor who understands the importance of maximizing function and planning for the future. But there is a serious shortage of geriatricians in this country. In 2011 there were only 7,029 certified geriatricians practicing in the United States—roughly half the number needed. And the numbers are falling as older geriatricians retire and the number of young physicians entering geriatric medicine declines.

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