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Is geriatrics a primary care or subspecialty discipline?
D B Reuben1, J Zwanziger, T B Bradley
1Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine 90024-1687.
Journal of the American Geriatrics Society
|April 1, 1994
Summary
Geriatricians primarily provide primary care to older adults, not consultative services. This finding supports considering geriatricians as generalists for health policy and education.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Physician Practice Patterns
Background:
- Geriatricians play a crucial role in the care of older adults.
- Understanding the nature of clinical care provided by geriatricians is essential for health policy and resource allocation.
Purpose of the Study:
- To differentiate the proportion of primary care versus consultative care delivered by geriatricians to older populations.
- To inform health policy and educational strategies regarding geriatric care.
Main Methods:
- A national survey was conducted.
- Participants included candidates for the 1988 geriatric certifying examination, interested non-registrants, and a comparison group of physicians.
- Data analysis was based on a 72% response rate.
Main Results:
- Approximately 78% of care by certified internal medicine geriatricians and 90% by certified family practice geriatricians for older adults was primary care.
- Internal medicine geriatricians provided a higher percentage of primary care compared to internists without geriatric interest.
- Even with formal training or subspecialty certification, geriatricians predominantly provided primary care (around 70%).
Conclusions:
- The majority of clinical care for older persons by geriatricians is primary care.
- Geriatricians function largely as generalists, impacting health policy and educational planning.
- These findings underscore the importance of geriatricians in the general medical landscape.