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General Internal Medicine and Geriatrics: Collaboration To Address the Aging Imperative Can't Wait
- From Veterans Affairs Puget Sound Health Care System University of Washington School of Medicine Seattle, WA 98108.
The progressive aging of the U.S. population presents an unprecedented demographic challenge to our health care system. To address this imperative, gerontology (the study of aging) and geriatrics (the health and social care of the elderly) must become embedded into medical education at all levels, especially the postgraduate training of all residents and fellows (except perhaps pediatricians). Furthermore, since the needs of elderly patients are typically chronic, progressive, and complex and the care of these patients is quintessentially multidisciplinary, communication and collaboration among specialists must be a cardinal feature of effective geriatric care. In this picture of the world of geriatric care, general internal medicine and family practice will share the leading role in primary care, skillfully orchestrating contributions from all of the medical subspecialties, neurology, psychiatry, physiatry, and surgery (including its subspecialties and related disciplines, such as anesthesiology and emergency medicine). This editorial focuses on partnerships between general internal medicine and geriatrics.
Where do geriatricians fit in this world? Here geriatrics functions as a “supraspecialty” (1), practiced by a relatively small cadre of certified geriatricians and their multidisciplinary teams concentrated principally in academic health centers. They maximally leverage their professional efforts as researchers and clinician-educators who provide exemplary, coordinated, longitudinal care to some of the oldest, most frail and vulnerable patients across a …
