This article has been medically reviewed by Dr. Martin Duggan in 2021
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
Men and women above the age of 65 often have unique health needs. They may have multiple health conditions, take a large number of medications, or feel uncertain about how to improve their health. A geriatric doctor, or geriatrician, is a physician who specializes in the care of senior patients. With advanced training beyond that of a typical primary care doctor, geriatricians are experts at managing age-related medical conditions and drug interactions. Geriatric doctors can do wonders for improving seniors’ quality of life.
Why would anyone need extra training to see an older patient?
As the human body ages, its physiology changes. Treatments, especially drugs, that work for patients at age 45 may no longer be appropriate for someone at age 85. The same is true for the results of certain blood tests, x-rays, and exam findings. Finally, patients older than 65 are more likely to suffer from multiple chronic illnesses. The intersection of these biology changes, the difference in the body’s ability to clear drugs, and the tendency to have multiple long-term illnesses pose unique challenges.
What training does a geriatric doctor have?
To become a geriatrician a physician must first complete a residency in either Family Medicine or Internal Medicine and then train for an additional year plus of fellowship training focused on the care of patients above the age of 65 years. This fellowship in elder care typically lasts from 1-3 years. Geriatric doctors work with the senior population and bring their knowledge of elder care to inform medical decisions.
How is a geriatrician different from a primary care doctor?
In the US, primary care doctors are those who have completed residency training in Family Medicine or Internal Medicine. Any primary care doctor in America has the training necessary to care for patients of all ages. As we mentioned above, people who are above the age of 65 frequently have unique medical needs that a family doctor may not encounter very often. In the case of younger people, a primary care doctor may recommend that they see a pediatrician. For patients above age 65, a primary care doctor might refer their patient to a geriatrician.
What does a geriatric doctor do?
The additional expertise that comes from so much extra training and a more narrow focus allows a geriatrician to approach their practice differently. A geriatric doctor will often have a big-picture approach for senior health and frequently avoid “polypharmacy” – a problem that commonly impacts the care of patients as they age. According to an article authored out of the Geriatric Fellowship program at the University of Alabama, polypharmacy is “defined as regular use of at least five medications.” From the same article, polypharmacy “increases the risk of adverse medical outcomes.” Polypharmacy is just one of many problems that geriatricians are uniquely qualified to recognize and fix. (Halli-Tierney, 2019)
Seeing a geriatric doctor
If your regular doctor is a primary care doctor, and you are over the age of 65 years old then there is no harm in asking whether a referral to a geriatrician makes sense.
How old should you be to see a geriatrician?
A geriatric doctor typically cares for patients 65 and older. However, age isn’t the only factor for seeing one. Below we’ll go over some red flags for patients who would benefit from seeing this type of doctor.
When should I see a geriatrician?
Not all seniors will need to see a geriatric specialist. However, seeing one can help many elderly patients, especially in the following cases:
- You’re taking more than 5 medications. These doctors are uniquely qualified to create a medication care plan that limits side effects.
- You’re experiencing a decline in mobility. Falls are a huge concern in the elderly population and often lead to other negative health conditions, and geriatricians often get special training in fall prevention strategies.
- You’ve recently been hospitalized. A recent hospitalization is a red flag that you should see a geriatric doctor. He/she can create a recovery plan that looks at the full range of your needs.
What conditions does a geriatric doctor specialize in?
Geriatric doctors are knowledgeable about a range of chronic health conditions and how they might influence each other. They will also work with other physicians as part of the senior’s overall care. Common senior conditions that geriatric care treats include:
- reduced mobility and falls
- arthritis and osteoporosis
- cognitive impairment and dementia
- vision and hearing impairment
- low weight and malnutrition
- weak immune system (prone to flu, pneumonia, etc.)
- hypertension and high cholesterol
- oral health
- sleep disorders
- depression and anxiety
These doctors will also help coordinate care across any chronic health conditions, including heart disease, strokes, respiratory disease, kidney disease, epilepsy, cancer, Parkinson’s disease, MS, etc.
What are the goals of visits to a geriatrician?
Geriatric care gives seniors a wide range of benefits for their well-being. Because these doctors are specifically trained to work with seniors, seeing one can be a morale boost for seniors too. Overall, benefits include:
- Use experience with aging bodies to see the big picture of a senior’s health and work to improve quality of life. Primary care doctors don’t have this same expertise. Geriatric doctors will look closely at how each medical decision affects the senior’s health and what can be modified to improve it.
- Schedule longer appointments for seniors to better discuss concerns and collect more information. This is a key benefit of getting geriatric care. Appointment times are often longer, as doctors need to get a clear picture of the senior’s current health and priorities.
- Prevent hospital stays with check-ups and medication care plans. Geriatric doctor visits are essential for preventing hospitalizations. Because they have an eye for senior-specific needs, they know how to prevent and manage common conditions before a serious health event occurs.
- Create informed medication management to address negative side effects. Medication management is absolutely critical for seniors who take multiple medicines. Often seniors complain about side effects or stop taking pills because they make them feel bad. These doctors have expertise in drug side effects and work to manage them so that these effects are neutralized.
- Coordinate care with other doctors for a holistic approach. Seniors often see a range of doctors, according to their health needs. A geriatric doctor coordinates care with other doctors so that a full range of needs are met.
- Provide end-of-life care, as needed. In addition, these doctors are always working to improve senior well-being, even when patients are reaching the end of their lives. They create care plans to keep them comfortable and address their needs even in that final stage.
- Give compassionate elder care where others may not. Geriatric doctors are used to working with older age groups. They understand the challenges of aging and work compassionately to provide care.
Paying for a consultation with a geriatric doctor
In this age of ballooning healthcare costs, more and more attention is rightly focused on the cost of care for patients. With medical bills as a leading cause of bankruptcy, most doctors will take absolutely no offense when a patient raises a concern about finances. In fact, most doctors are themselves worried about ordering tests, prescribing medications, or making referrals that cost money but don’t improve health. Seeing a primary care physician is often less expensive and puts less burden on the healthcare system overall. However, if careful management of a patient’s health can save them from a future trip to the hospital, then sometimes even the financial savings are enough to justify a referral to a geriatrician – say nothing of the benefit to the person’s health.
How much does a geriatrician cost?
The bill for a geriatric care visit varies greatly depending on where you live and what your needs are. It will also depend on whether you have Medicare, Medicaid, or private insurance. Remember to consult about costs before scheduling your geriatric appointment.
Does Medicare cover geriatric care?
Yes, doctor visits including geriatric doctors are covered by Medicare’s Part B benefits, as well as most Medicare Advantage plans. To have the cost of your visit covered, you must choose a doctor that accepts Medicare. For Medicare Advantage, you may also need a referral from your primary care doctor for the costs to be covered.
Does Medicaid cover geriatric care?
Yes, Medicaid also covers geriatric doctor visits. In particular, Medicare covers almost all long-term care, of which geriatric care is a part. You’ll have to find a doctor that accepts Medicaid.
Does private insurance cover geriatric care?
Many private insurance providers cover geriatric care. However, you’ll need to check the conditions of your specific healthcare plan to find out more.
As you begin your search for geriatric care, you might first ask for recommendations from family or friends. It’s a good idea to ask about each doctor’s training, insurance access, communication style, and working philosophy.
How can you find a good geriatric doctor?
You can start your search for a good geriatric doctor on My Caring Plan. Here you’ll find a range of options for geriatric care in your area. At the same time, you can get more resources on senior care, including everything about geriatric care centers and more.
- Specialists in Aging: Do You Need a Geriatrician?, Hopkins Medicine, www.hopkinsmedicine.org
- What does a geriatrician do?, Health Direct, www.healthdirect.gov.au
- When It’s Time to See a Geriatrician, AARP, www.aarp.org
- Polypharmacy: Evaluating Risks and Deprescribing, www.aafp.org
- Warshaw, Gregg A, and Elizabeth J Bragg. “The training of geriatricians in the United States: three decades of progress.” Journal of the American Geriatrics Society vol. 51,7 Suppl (2003): S338-45. doi:10.1046/j.1365-2389.2003.51345.x
- Counsell, Steven R et al. “Geriatric care management for low-income seniors: a randomized controlled trial.” JAMA vol. 298,22 (2007): 2623-33. doi:10.1001/jama.298.22.2623