Geriatric practice. Taking up where primary care leaves off

Medical Education Responds to the 20th Century's Success Story

“…Projected Needs In 1978, the Institute of Medicine (IOM) described a specific body of knowledge regarding aging, emphasized the skills and attitudes relevant to the education of physicians and the practice of geriatrics and made a series of recommendations summarized in Table 1 1 . Although some physicians continue to assert that no differences exist among the concerns of all primary care practitioners, including general internists, family physicians, and geriatrician specialists, evidence is accumulating that there are many 2 . Many factors combine to complicate the care of elderly patients.…”

Geriatric Practice Revisited: Toward Collaboration with Primary Care Medicine

“…About 15 years ago, Claire Maklan—then of the Office of Technology Assessment—and I, wrote an Editorial entitled “Geriatric Practice. Taking up where primary care leaves off.” 1 At that time, we were aware of a “primary care crisis,” 2 the exciting prospects then unfolding of the “emergence of geriatrics,” and the inherent strengths this field—so new in the American academic medical establishment—brought to the broader healthcare environment.…”

Response to the Report of the Institute of Medicine: Academic Geriatrics for the Year 2000

“…Whereas the Committee's goal of producing academic geriatricians is laudable, we feel that additional intensive and concurrent efforts must be made to disseminate the knowledge of geriatric practice to the large community of general internists and family practitioners 6 . Several new approaches are needed that provide a “continuum” of experience and programs in aging to a broad constituency: a) the introduction of humanistic and biological aspects of aging to those students at the college level destined for a career in the health professions; b) a curriculum over the four years of medical school which includes supervised clinical experience with older patients in the ambulatory setting and the home; c) implementation of geriatric teams that disseminate the educational principles and practice of interdisciplinary care for the elderly to house staff on all services within the hospital setting; d) enhancement of the role of geriatric nurse practitioners through close professional collaboration with physicians and other health professionals; and e) postgraduate exposure for internists and family medicine practitioners in the community, using a nursing home with strong links to an academic geriatric center as a “classroom” for such teaching.…”