“The geriatric assessment up front is essential to find out what the patient’s and family’s goals of care are,” says Dr. George. “If they’re 80 years old and want to stay at home, we need to help them do that safely. That may mean linking them to the [visiting nurse service], a home aide, or adult day care.”
She points out that an inpatient stay also offers seniors the opportunity to be seen by subspecialists and do a lot in a short period of time. “As a hospitalist geriatrician you can see change almost immediately; you can have an impact,” she concludes.
As the hospitalist movement affords career opportunities to geriatricians, young physicians can obtain financial incentives to pursue a career in geriatrics. For instance, in 2006 South Carolina enacted a Geriatrician Loan Forgiveness program, helping physicians to repay up to $35,000 of medical school loans if they complete a geriatrics fellowship and practice in South Carolina for five years after completing medical training.
Victor Hirth, MD, medical director for the Division of Geriatric Services of Palmetto Health of Columbia, S.C., has recruited eight geriatric fellows, two of whom will be hospitalists. A recent recruit, Andres Leone, MD, went to medical school in Ecuador, recently completed a geriatric fellowship in South Carolina, and works as a hospitalist half time and at a free clinic for Hispanics half-time. “The flexibility to work as a hospitalist and in an outpatient clinic feels right to me,” says Dr. Leone.
While the number of geriatric hospitalists today is small, some predict their growing presence is inevitable.
“The baby boomers will deluge us, and they will demand so much more of hospitalists in the near future,” Dr. Sherman says. “They will have complicated issues and be very inquisitive geriatric patients.” TH
Marlene Piturro is a frequent contributor to The Hospitalist.
References
- Wald H, Huddleston J, Kramer A. Is there a geriatrician in the house? Geriatric care approaches in hospitalist programs. J Hosp Med. 2006 Jan;1(1):29-35.
- Shah U, Aung M, Chan S, et al. Do geriatricians stay in geriatrics? Gerontol Geriatr Educ. 2006;27(1):57-65.