Elderly Patients: The Patients Doctors Don’t Know
Rosanne M. Leipsig, a physician and professor of Medicine at Mount Sinai School of Medicine, published an article in the New York Times (7/1) commenting on the fact that “American medical schools require no training in geriatric medicine,” even though elderly patients make up a substantial component of all patients for which graduating doctors will care. She and some of her colleagues published a “Don’t kill Granny” checklist in the Journal of Academic Medicine, which laid out the basic requirements all graduating medical students should demonstrate in caring for elderly patients.
All doctors in training are “required to have clinical experiences in pediatrics and obstetrics, even though after they graduate most will never treat a child or deliver a baby. Yet there is no requirement for any clinical training in geriatrics, even though patients 65 and older account for 32 percent of the average doctor’s workload in surgical care, 43 percent in medical specialty care, and they make up 48 percent of all inpatient hospital days. Medicare…contributes more than $8 billion a year to support residency training, yet it does not require that part of that training focus on the unique health care needs of older adults.”
For Example, an experienced doctor needs to be aware that a 50-year-old body will respond differently than an 80-year-old body to both illness and medication. “Pneumonia in a 50-year-old causes fever, cough and difficulty breathing; an 80-year-old with the same illness may have none of these symptoms, but just seem ‘not herself’ - confused and unsteady, unable to get out of bed.” Not only are the symptoms different by age, but also the dosage of medication; a 50-year-old body can handle nearly twice as much medication as an 80-year-old body. Over prescribing medication to any patient, but especially one who is elderly, can cause severe kidney damage with long-term health consequences.
As a medical malpractice lawyer with experience in cases dealing with elderly care, I support a geriatric care requirement in medical schools. As the baby boomers get older, geriatric care is only going to become more important.