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Haims column: More geriatricians are needed in our area

Judson Haims

Choosing a primary care physician can be challenging for people of any age. However, if you are a senior living in our mountain communities, choices are more challenging as providers that specialize in caring for this population are limited.

Here in Garfield County, while we have providers who have a special focus on geriatrics, there are no board-certified geriatricians. In Eagle County and Summit County, there are no board-certified geriatricians nor any providers who specialize in geriatrics. Rather, there are a few family practitioners that manage care for more older patients than other practitioners. Therefore, many family medicine providers are treating this elder population.

A while ago, I read an article in the Journal of the American Board of Family Medicine that stated, “Perhaps a major reason that so many family physician geriatricians spend so much of their time doing geriatrics is because of the demand. Older adults account for 26 percent of all physician office visits, 34 percent of all prescriptions, 35 percent of all hospital stays, and 90 percent of all nursing home residents.”



In the U.S., we have about 7,000 board certified geriatricians to serve more than 69 million people aged 70 and older. The nature of supply and demand dictates that these specialists provide services where their need and demand is greatest. Consequently, it is not hard to understand why our mountain communities of Summit, Eagle and Garfield counties lack these specialists. With less than 10,000 people 70 and older within our mountain communities, we are only recently making it viable to support geriatricians.

UNDERSTANDING UNIQUE NEEDS



Since providers specializing in the needs of older patients are more limited within our mountain communities than metropolitan areas, personal referrals from friends, families and co-workers can be helpful in finding the right provider for your needs. As well, you can always call our office. We advocate for many elder people and are always happy to share information and resources our clients share with us.

For those of us who are “older,” it comes as no surprise that our medical needs are more complicated. We are complex patients with symptomology that is often atypical and complicated by normal changes of aging.

Often, older adults do not display the typical signs and symptoms of illness.

For example, one local doctor friend just shared with me last week that he has seen an increase in older adults with pneumonia. Typically, some signs of pneumonia include fever, chest pain when breathing or coughing, mucus that is greenish or yellow, fatigue, excessive sweating and clammy skin. However, in older patients, often fever may not present itself and confusion (dementia), lower than normal body temperature, and impairments in swallowing and cough reflexes may be indications of the illness.

Because older adults often present illness differently, often with nonspecific symptoms as opposed to more suggestive symptoms, medical providers more versed in an aging population may catch the identifying signs of the illness more frequently.

THE RIGHT PROVIDER

Nothing can really give you a feel for whether you’ve selected the right doctor like an office visit and a face-to-face meeting. Be sure you feel comfortable in the office, with the physician, and nurses. Your PCP should be someone you trust and can rely on to help manage your health care.

When in the office, you should evaluate the demeanor of the office in whole. Do the people who answer the phones seem polite, caring and considerate? Are the phones answered in a timely manner? How well an office presents itself and its services provides great insight to the services and quality of the medical providers.

In today’s medical environment, managing your own health care must be the responsibility of the patient. If your medical provider is not proactive in your health care after you leave the office, if the provider is rushed while visiting you in the exam room, and if you feel you are not having your questions answered in a manner you truly understand, engage your provider. They sometimes may need to be politely reminded that you need their full attention.

Some providers in our mountain towns have started offering the services of social workers within the clinics. These people help navigate patients to specialists arrange special needs/services, and follow up on your care after your medical visit with the doctors. Offices that offer this service are progressive and demonstrate that they care about your complete health needs.

Judson Haims is the owner of Visiting Angels Home Care in Garfield and Pitkin counties. His contact information is, http://www.visitingangels.com/comtns , 970-328-5526


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