Here’s why you should consider seeing a geriatrician

It comes as second nature for most parents to take their children to a pediatrician at least once a year. The differences between children and adults are so stark that it makes sense to choose a doctor specially trained to treat younger patients.

Yet as we age, far too few of us apply this same logic when choosing a physician, even though our health needs often change dramatically in our later years. 

“The kind of care older adults require is more complex than the needs of a middle-aged person,” said Rhonda L. Randall, D.O., a geriatrician and chief medical officer with UnitedHealthcare. “We become more different than our peers as we age and the physiology of older people becomes very different from people in other stages of life.”

Those differences are significant enough that the medical community developed a specialty called geriatrics, to address the needs of older adults, particularly those who are frail. Geriatricians like Dr. Randall are licensed physicians who have completed additional training in the care of older adults. 

As we age we are more likely to develop chronic conditions, such as high blood pressure, diabetes and heart disease. Nearly 79% of older adults have more than chronic condition.¹ More than 90% of older adults with cancer have one or two chronic conditions, a third have more than three.² And, over half of adults over the age of 65 are living with four or more chronic conditions.³

Juggling multiple chronic conditions can be a challenge for the doctor, the patient and their caregivers. One condition can make the effects of another condition worse, and the treatments or medications for different illnesses sometimes interfere with each other. Having someone who is trained with this in mind may often result in more comprehensive, whole-person, patient-centered care. 

Nearly 90% of adults 65 and older take at least one prescription medication.⁴ What’s more, over 4 in 10 adults aged 65 years or older reported using five or more prescription medications.⁵

Decisions about how to customize a patient’s treatment aren’t necessarily black and white, requiring a prescriber and patient to have shared decision-making conversations that balance risks and benefits. For example, some diabetes medicines can cause dizziness, meaning the doctor needs to focus not just on regulating the patient’s blood sugar but also on minimizing the risk of a fall, which is the most common cause of injury in seniors.⁶ A geriatrician helps weigh a person’s overall quality of life goals with a treatment plan that keeps things like comfort and independence in mind.

In the care of seniors we often see a risky "prescribing cascade" – where a new medication is prescribed to treat the side effects of another medication, rather than stopping or changing the medication that caused the side effect in the first place.

“I think geriatricians may be the only medical specialty more interested in stopping medications you no longer benefit from rather than prescribing you a new medication. A lot of what we do is start with understanding a senior's goals of care when determining which medications are more likely to cause harm than help,” Dr. Randall said. “We ask patients, what matters most and what trade-offs are you willing to make?”

In addition to the clinical aspects of an individual’s care are the complexities of variables commonly referred to as social drivers of health – things like access to healthy food, financial burdens, disparities, transportation limitations and more.

Many older adults are dealing with these potential barriers to health, and as Dr. Randall noted, a geriatrician can help support his or her patients in identifying and addressing these challenges alongside their regular care plan.

“Geriatricians are very good at balancing all of a person’s medical, behavioral and social and specialty care needs in one comprehensive care plan,” Dr. Randall said. 

There are fewer than 7,000 geriatricians across the U.S.⁷ And this number has decreased in recent years. For this reason, finding a board-certified geriatrician to support your ongoing health care needs may be difficult, but many geriatricians will see a patient on a one-time consult to provide a comprehensive geriatric assessment or as-needed basis and then make recommendations to the patient’s primary care provider.

Seeing a geriatrician may be particularly beneficial for people over the age of 75, those who are living with multiple chronic conditions, need caregiver assistance with their activities of daily living, are concerned about memory loss, or are taking multiple medications.

The American Geriatrics Society offers information about how to find a geriatrician on its website, and many larger hospitals and university medical centers have geriatricians on staff who will see new patients.

If you’re enrolled in a Medicare Advantage plan, be sure to confirm if the geriatrician you want to see is in your plan’s network and whether your plan requires you to first get a referral from your primary care provider or the visit to be covered under your plan.