geriatrics

[markglt]

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mods...can we get a geriatrics forum going??👍

 

[deleted87716]

mods...can we get a geriatrics forum going??👍

I'm not a mod anymore, but...typically, new forums are created when there is sufficient traffic in an existing forum on a given subject to warrant the creation of a sub-forum.

I can't remember the last time we had a thread about geriatrics.

Maybe you could start one. 😉

 

[primadonna22274]

I'll bite. Leaning heavily this direction but can't decide whether to do FM with heavy adult emphasis (flexible and good for rural practice), IM with or without Geri fellowship, or Neuro with behavioral neuro/dementia focus (obviously couldn't be the rural family doc in this scenario). Also have a palliative care interest and any of these is eligible for HPM fellowship/cert. Currently MS-1 but 11 yr as PA in EM, FM. I like IM best and can't stand OB and don't enjoy peds (e.g. parents).
Started a geri club at our school and really would like to define what are core competencies for basic Geri education for the non-geriatrician? Aging baby-boomers and all that...trying to convince my classmates that they should learn and will treat these folks.

 

[CherryTree1305]

There is such a need for physicians that specialize in geriatrics. Even in the suburbs of large cities, it is difficult to find someone in that specialty. With us boomers coming on scene, it is only going to become more needed. I hope many new MD's are considering this specialty.

 

[jcm5189]

MSIII interested in geriatrics and palliative care as well. Can you update me on your most recent experiences and decisions? @primadonna22274

 

[jm192]

I'm curious as to the benefits or advantages for you and your patients.

Obviously, a fellowship gives you more experience treating certain conditions encountered by the geriatric population. But, do you not get a lot of that same experience out in the world practicing?

 

[primadonna22274]

MSIII interested in geriatrics and palliative care as well. Can you update me on your most recent experiences and decisions? @primadonna22274

LOL I'm still undecided. Applying now to mostly IM, a couple IM/psych (love Geri psych) and a handful of FM programs. More likely to do a palliative med fellowship than Geri but can enter that from many avenues.

 

[DIce3]

A geriatrics fellowship makes sense for the family physician who realizes that eight months of residency training in internal medicine are inadequate to prepare for caring for the complicated older adult. After three years of a categorical internal medicine residency, however, the one year geriatrics fellowship probably provides little. The vast majority of an internal medicine residency is essentially geriatrics.

 

[MedicineDoc]

A geriatrics fellowship makes sense for the family physician who realizes that eight months of residency training in internal medicine are inadequate to prepare for caring for the complicated older adult. After three years of a categorical internal medicine residency, however, the one year geriatrics fellowship probably provides little. The vast majority of an internal medicine residency is essentially geriatrics.

You are seriously delusional.

I haven't calculated up the amount of time I spent in the hospital but it was MOST of the time. There was hospital call even after outpatient clinic. There were patients in the hospital including the ICU that had to be rounded on in the morning. I believe the idea that IM gets almost no outpatient training is actually a negative for ability to treat hospitalized pts ie admitting BPPV and ordering thousand dollar MRIs for BPPV. I got more than enough inpatient AND OUTPATIENT training to be completely comfortable in the hospital. Maybe the real question should be did you get enough outpatient training to even know what can be treated outpatient or learn much specialty medicine such as Ortho, ENT, Opthalmology etc. We also had pulmonology and critcal care rotations in addition to seeing ICU pts daily. Of course these specialists goal was to educate on the most important topics and what needs to be done including whether they require hospitalization and/or specialty consult. Outpatient is not a different species and you should stop suggesting it has no value in taling care of patients regardless of what setting your pt us in. You should be able to accomplish goals that are core measures in hospitalist medicine that bleed directly into outpatient where your patient is going after discharge not the planet Mars. Hospital medicine is the same medicine just with more resource such as and nursing monitoring/ respiratory therapy and ability to monitor labs, tele, and vitals and supllement oxygen by various means. There are more FM docs seeing their pts in the hospital than there are total hospitalists and there have been for YEARS. The society of hospitalist medicine recognizes FM doctors as trained in hospital medicine and there is a pathway for hospitalist certification just as there is in IM. Also your definition of internal medicine as some separate entity from the knowledge base of FM is laughable.

 

[DIce3]

You are seriously delusional.

I am done attempting to provide assistance on this thread.

 

[deleted87716]

A geriatrics fellowship makes sense for the family physician who realizes that eight months of residency training in internal medicine are inadequate to prepare for caring for the complicated older adult.

FWIW, we don't do any training in "internal medicine."

I should add that while training in internal medicine might (arguably) make one a good hospitalist, it does not necessarily make one a good geriatrician. Last time I checked, the ACP was billing itself as "doctors for adults," not "doctors for old people."

 

[VA Hopeful Dr]

FWIW, we don't do any training in "internal medicine."

I should add that while training in internal medicine might (arguably) make one a good hospitalist, it does not necessarily make one a good geriatrician. Last time I checked, the ACP was billing itself as "doctors for adults," not "doctors for old people."

Between residency and now out in the real world, I've come across 5 geriatricians between 2 smallish southern towns. All 5 were fellowship trained internists.

If it didn't add much, why did they do it? Its certainly not for more money.

 

[jm192]

Between residency and now out in the real world, I've come across 5 geriatricians between 2 smallish southern towns. All 5 were fellowship trained internists.

If it didn't add much, why did they do it? Its certainly not for more money.

I think he's saying IM vs FM, not necessarily fellowship.

That said, I posed earlier--what's the point of the fellowship?

I've spent hundreds of hours with family medicine docs that take care of numerous geriatric patients and manage all of their illnesses/conditions. Not once have I seen them refer one to a geriatrician.

 

[VA Hopeful Dr]

I think he's saying IM vs FM, not necessarily fellowship.

That said, I posed earlier--what's the point of the fellowship?

I've spent hundreds of hours with family medicine docs that take care of numerous geriatric patients and manage all of their illnesses/conditions. Not once have I seen them refer one to a geriatrician.

I was agreeing with BD and adding my own experience.

The fellowship is, like most 1 year fellowships, mostly extra exposure with, in this case, more experience with complicated geriatric patients. Also, to my understanding, more nursing home time.

 

[Adult Recon]

VA Hopeful is correct about much more nursing home exposure. Would being board certified in Geriatric Medicine bring a higher salary in the long run? Just asking.

 

[primadonna22274]

VA Hopeful is correct about much more nursing home exposure. Would being board certified in Geriatric Medicine bring a higher salary in the long run? Just asking.

Not necessarily more salary but SC does offer $30k loan repayment to folks who complete the Geri fellowship and practice geriatrics for 5 yr in the state...so definitely a consideration if you owe $$$ like I do and plan to practice here anyway 🙂

 

[VA Hopeful Dr]

VA Hopeful is correct about much more nursing home exposure. Would being board certified in Geriatric Medicine bring a higher salary in the long run? Just asking.

If you're just a regular ole practicing doctor... probably not. That said, all the geriatric trained FPs I knew from residency supplemented their income with nursing home work - something that regular FPs don't usually do.