Is geriatrics a primary care or subspecialty discipline?

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.