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General Internists and Family Physicians: Partners in Geriatric Medicine?
- James W. Mold, MD, MPH;
- Larry A. Green, MD; and
- George E. Fryer, PhD
- From University of Oklahoma Health Sciences Center; Oklahoma Center for Family Medicine Research; and The Robert Graham Center; Washington, DC 20036.
The articles in the supplement to this issue of Annals (1-4) reveal internal medicine as a discipline committed to geriatric medicine. Internal medicine is not alone. Family physicians, who provide more office-based visits than any other specialty in the United States, are also taking steps to ensure adequate training in geriatrics.
Our discipline published its own alert in Family Medicine in 1995. In this position paper, the Group on Geriatric Education of the Society of Teachers of Family Medicine (STFM) offered specific suggestions for enhancing undergraduate medical education, residency training, faculty development, and continuing professional education (5). A subsequent series of articles in the same journal outlined recommendations from a series of retreats for family medicine residency directors (6), an update to the 1995 report from the STFM Group on Geriatric Education (7), a report of a national survey on the current status of family medicine residency education in geriatric medicine (8), and a critical commentary on recent changes in the language of the Family Medicine Residency Review requirements for geriatric education (9).
We agree that fellowship training is not going to be the whole answer. Currently, accredited family medicine geriatric fellowship programs offer 68 positions, of which 58 were filled in 2003. General faculty development fellowship programs in family medicine offer 144 positions, of which 137 were filled in 2003. Too few family physicians are preparing for careers in geriatrics.
The goals, strategies, and obstacles identified by general internists in this issue are similar to those identified by family physicians. This congruence of purpose invites continued, more robust collaboration between general internists and family physicians. To that end, we discuss the patterns of service for elderly patients and try to place geriatric education into the broader perspective of primary care. We start by …
