You may have a primary care physician (PCP) you trust and rely on to keep you healthy and refer you to specialists as your medical needs change. But as you get older you may also wonder whether it’s time to have a geriatrician in that role instead of a traditional PCP.
It’s an important consideration, but there isn’t necessarily a clear-cut choice that’s right for everyone. A geriatrician is a type of primary care doctor who has additional education and experience in treating older adults, particularly those who have several chronic or complex health problems. A traditional PCP treats patients of all ages and focuses on preventive care as well as managing both acute and chronic health concerns.
While geriatricians focus on caring for people ages 65 and older, many older adults don’t necessarily need a geriatrician if they are in generally good health.
Reasons to Choose a Geriatrician
Geriatricians can be especially helpful in coordinating the care for older people coping with several health problems, such as cognitive decline, heart failure, or osteoporosis. They can manage the care provided by the specialists on your health care team and give you advice with your overall health and well-being in mind. While a traditional PCP may be effective in this role, too, a geriatrician’s training is focused on managing the many health concerns common to older adults, including dementia, frailty, incontinence, and changes in everyday function and independence.
Geriatricians are also experienced in providing palliative care and helping individuals with end-of-life care. They are used to working with caregivers and often schedule longer appointments to thoroughly review prescriptions and other treatment from your various doctors. If you are taking multiple medications prescribed by more than one doctor, a geriatrician can be helpful in determining any potential drug interactions and recommending which medications may be unnecessary or may be safer or more helpful at a lower dosage.
Reasons to Choose a PCP
If you have been working with a traditional PCP for several years and feel comfortable and confident that your doctor is providing you optimal care, then you may not feel the need to make a change. Having a doctor who is familiar with your medical history and with whom you have a good relationship is valuable.
You may also prefer a PCP who has a subspecialty that fits your health needs. For example, many traditional PCPs are internal medicine physicians, or internists, who may have a particular focus in areas such as endocrinology or rheumatology. If you have thyroid disease or rheumatoid arthritis and your PCP specializes in treating one of those conditions, you may want to continue working with that doctor.
If you are currently in good health, take no more than one or two medications, and are not coping with multiple chronic conditions, you may not need a geriatrician yet. As you get older and your health concerns become more complicated, then it may be time to find a geriatrician to act as your primary care provider. Many people don’t start seeing a geriatrician until they are around 75 years old or older.
Other Considerations
When it comes to choosing any type of doctor, one of the most important considerations is availability. Living in a community that doesn’t have many PCPs or geriatricians to choose from means finding the best fit from the physicians who are easily accessible.
Unfortunately, there are fewer and fewer primary care doctors and geriatricians entering the workforce these days. Research suggests that, despite the increasing numbers of older adults in the U.S. population, the number of geriatricians has actually been shrinking in recent years.
You may also consider having both a traditional PCP and a geriatrician on your health care team. You may rely on your PCP for regular checkups and preventive care and a geriatrician for managing your chronic health conditions. You should check with your insurance carrier about coverage for both a PCP and a geriatrician. It may not be an issue, but you’re always better off asking first before making any major decisions about your health care providers.
You may also opt to keep your PCP and consult with a geriatrician from time to time as new concerns surface. If, for example, memory lapses or personality changes emerge, getting the perspective of a geriatrician may be helpful, especially for a caregiver looking for advice about how best to respond to changes affecting their loved one.
Questions to Ask Your Doctor
When you’re ready to start making a decision about a traditional PCP or geriatrician, here are some questions to ask your current or prospective PCP:
- Do you have many older patients now or much experience working with older adults?
- How much experience do you have treating my particular condition or set of conditions?
- Do you feel that I would benefit from seeing a geriatrician, or are there circumstances in which you would recommend I see a geriatrician?
Keep in mind that not everyone over the age of 65 needs a geriatrician. The choice of a traditional PCP or geriatrician depends less on age than on the complexity and severity of your health problems. If you currently have a traditional PCP, talk with your doctor about whether turning to a geriatrician makes sense.
Show Sources
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SOURCES:
American Academy of Family Physicians: “Primary Care.”
American Geriatrics Society: “Projected Future Need for Geriatricians.”
Health in Aging: “Geriatrics.”
Johns Hopkins Medicine: “Specialists in Aging: Do You Need a Geriatrician?”
Journal of Aging and Health: “The Looming Geriatrician Shortage: Ramifications and Solutions.”
Mount Sinai: “What Is Geriatrics?”
