American physicians began writing about childhood diseases in the mid-1800s. An early advocate, Dr. Abraham Jacobi first taught about childhood disease in 1861 and later opened the first department of pediatrics at a general hospital. Despite these initial movements, in the early 19th century, physicians still treated children like small adults with few exceptions. It took a great deal of effort to finally convince the established medical profession that children responded differently to medications, exhibited conditions unique to their age group and that developmental, social and family needs impacted their care and ultimately their outcomes. Although we consider it the norm today, the American Academy of Pediatrics wasn’t established until 1930 and the American Board of Pediatrics came into being in 1933.
In much the same way, geriatrics faces many of the same parallels. As early as 1848, George Edward Day complained that other physicians had little interest in caring for the aging. Little wonder since even then the emphasis was on preventing aging rather than caring for those who had aged, as can be seen in a final address by William Osler, a famous Canadian physician. Osler’s last address stated that men over 40 were relatively useless and men over 60 were absolutely useless and advocated chloroform for treatment. With opponents like Osler, geriatric medicine didn’t really get off the ground until 1946 when the British House of Parliament heard about the care of the aged and chronic sick from Lord Amulree and Dr. Sturdee.
The point of this account is that geriatrics as a practice is still very young. Much like early pediatrics, geriatrics is still working to gain recognition from medical professionals and the public that older people aren’t just younger people with more history. They are far more likely to have multiple chronic disease, different (medical) presentations and responses to diseases, and complex syndromes. Acute care specifically directed towards the needs of older people such as the care provided by geriatricians, geriatric nurses and even geriatric hospitals recognizes the interdependency of medical, mental and social health issues of older adults and can optimize their health and wellbeing.
For instance, diseases such as Alzheimer’s disease and other dementias require a different skill set along with the ability to work with patients and caregivers. In addition, the sickest and frailest of older patients often visit multiple locations, multiple health care providers and may even live in multiple locations as they move between home and skilled nursing and emergency rooms.
Geriatrics has seen numerous advances and, possibly thanks to the Baby Boomers, they are experiencing some success as a field. A 2002 article found that geriatricians had the highest professional satisfaction rating among physicians. However, recruitment is low–far too low for the number of Americans reaching 65 each day–and financial support for education, research and payment for clinical care tanks out at the bottom of the pile.
Finding a geriatrician who is accepting new patients can be like looking for a needle in a haystack. However, if you’re concerned about any of the health issues such as frailty, multiple chronic conditions, multiple medications, mental decline, or deciding when it might be time to hire a caregiver, either for yourself or a loved one, it may be time to add a geriatrician to your healthcare team. Contact our office for a list of geriatricians in your area.