So a week ago I read two articles in the NYT about medical resources/solutions for caring for older patients. The first article points out that there is a lack of interns/residents student choosing to be become board certified geriatricians (like pediatricians for old people). The pay is lower and the slow grind of taking care of older patients is not a selling point http://www.nytimes.com/2016/01/26/health/where-are-the-geriatricians.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=mini-moth®ion=top-stories-below&WT.nav=top-stories-below&_r=0 I guess between choosing to go into oncology or becoming a plastic surgeon becoming a geriatrician lacks luster. And of course, the profession pays less as Medicare pays less. I distinctly remember my first PCP visit after going on medicare when my lovely PCP did everything necessary for my visit but at a much faster pace.
I guess part of the rational for interns and residents is that you can not cure old age. The number (7000) geriatricians in this country needs to double to take care of that aging demographic that we are. One of the folks who wrote comments on this article points out that in England the price of taking care of older patients goes up with age! Another person comments and asks the question, shouldn’t all doctors become more familiar with the needs of aging patients. But just as you want a pediatrician who knows well the latest complexities in childhood diseases, you would hope to have someone who can help prevent things like medication induced dementia and be totally up on advances in medicine for advanced age people.
So next I read an article on the rise of geri -science. It sounded less like science fiction the second time I read it. This approach is to find a drug/supplement that will prevent the major diseases that aging folks are susceptible to. It all comes down to anti inflammatory treatment. I love the simplicity of the line, age is a risk factor, http://well.blogs.nytimes.com/2016/02/01/pursuing-the-dream-of-healthy-aging/?hpw&rref=health&action=click&pgtype=Homepage&module=well-region®ion=bottom-well&WT.nav=bottom-well&_r=0. Of course there is always the mention of how much money this saves. Again the real trials for this are 5 years off.
I guess this goes back to the first reference in the article to a Dr Fries’s idea of compression of morbidity, that is you live relatively well until age 85 then “drop off in a short decline”. Reminds me of a favorite line from a good old people movie Still Mine, where the father says to his son, “Well I guess this is where is when I start my slow inevitable decline” . Is that all the most of us our age can expect in the best of circumstances? Can we live well then kind of magically evaporate without burdening those around us? But isn’t that what we re trying to do on our own? So will Geri- science make up for the lack of Geriatricians?
As the old song goes you can’t always get what you want , but maybe if you try sometime , you get what you need.