Judson Haims: Geriatrician shortage in Colorado mountain communities tough for seniors
Choosing a primary care physician (PCP) can be challenging for people of any age. However, if you are a senior living in our mountain communities, choices are more challenging as providers who specialize in caring for this population are limited.
In Summit, Eagle, Garfield and Pitkin counties, we currently have no board-certified geriatricians. While there are a few family practitioners who manage care for more older patients than other practitioners, none are specialists.
With the State of Colorado Demography Office estimating about 15,000 people 70 years and older within our Western Slope mountain communities, should we not be able to substantiate the need for at least one board-certified geriatrician?
In a report from the National Resident Matching Program (an organization that places medical school students into residency training programs), data show that of 387 fellowship positions available in 2018, only 176 were filled. So, it’s with little surprise that the nature of supply and demand dictates that these positions are offered where their need and demand is greatest. Unfortunately for our Colorado mountain communities, that demand has not been substantial enough for us motivate a provider to set up shop.
Since medical providers specializing in the needs of older patients are so limited and/or nonexistent within our mountain communities, we are forcing our elder population to seek medical treatment outside of our communities. This has high economic and social costs.
In 2012, Dr. Stephan Weiler, economics professor and Associate Dean of research in the College of Liberal Arts at CSU, supervised a study that projected the economic loss within Eagle and Summit counties as baby boomers sought suitable medical care solutions elsewhere. The study estimated an annual economic loss of $43 million to the economy of Eagle County. For Summit County, the loss was estimated at $28 million.
Regardless of whether you believe this financial cost to be low or high, there is a socioeconomic cost that may be greater. When communities don’t embrace an elder generation, when we only venerate youth, we lose a connection to our own place in the cycle of life. Moreover, we create a disconnect between generations and forfeit the opportunity to pass on knowledge and wisdom.
For those of us who are “older,” it comes as no surprise that our medical needs are more complicated. We are complex patients with symptomology that is often atypical and complicated by normal changes of aging.
Geriatricians are trained to see the big picture. For example, it is not uncommon for older adults to take many medications prescribed from different doctors who treat different ailments. Occasionally, this can cause problems with negative effects that may occur from taking multiple medications. A geriatrician can help prioritize which drugs are necessary and which can be skipped.
As Johns Hopkins geriatrician Dr. Samuel Durso states, “The role of the geriatrician is to coordinate overall care with other physicians and guide the patient in making treatment choices.”
Geriatricians are experts in complexity. They understand how multiple medical problems interact and affect the quality of life in older people. If you feel that there is any disconnect between you and your different medical providers or, if you feel that you may be taking too many different medications, a geriatrician could add to your quality of care.
While there are currently no geriatricians locally, this does not mean you have to be without. The University of Colorado Hospital(s) in Denver have an excellent group of geriatricians. You don’t need a referral — just call 720-848-3400, explain your needs and their schedulers will make you an appointment with a specialist that will meet your needs.
For an appointment, there are two options: a single consultation for a specific geriatric concern or to set up the physician in their seniors clinic as the specialty primary care provider.
Consultation for a specific geriatric question: memory loss/evaluation, polypharmacy (too many medications), falling or at risk of falling, which would be a single visit with one of their geriatricians. After this type of consultation, a geriatrician will communicate their findings and suggestions to your primary doctor.
Should you choose to have a UC Health provider oversee your total health care and be your specialty primary care provider, your primary care provider here in the mountains will still provide care, but won’t be your primary as a patient cannot see two primary care providers due to insurance regulations (i.e. you cannot see someone in the mountains and at UC Health for primary care).
In today’s medical environment, managing your own health care must be the responsibility of the patient. If you feel that the standard 15-minute medical appointment is not enough time to address your medical needs, and if you feel you are not having your questions answered in a manner you truly understand, you should consider a consult with a geriatrician.
You should always check with your insurance provider before making any changes to the doctors you visit.
Judson Haims is the owner of Visiting Angels Home Care in Aspen, Basalt and Carbondale. He is an advocate for our elderly and is available to answer questions. His contact information is http://www.visitingangels.com/comtns, 970-328-5526.
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