Family Physician Geriatricians Do Mostly Geriatric Care: Is This a Problem for Our Specialty?
Kenneth Brummel-Smith, MD
+ Author Affiliations
From the Department of Geriatrics, Florida State University College of Medicine, Tallahassee.
Corresponding author: Kenneth Brummel-Smith, MD, Department of Geriatrics, Florida State University College of Medicine, 1115 West Call St, Suite 4305, Tallahassee, FL 32306-4300 (E-mail: firstname.lastname@example.org).
In this issue, Peterson et al1 report that the majority of family physicians with Certificates of Added Qualifications (CAQs) in Geriatrics self-report practicing primarily geriatrics. Almost 40% of those surveyed reported spending >80% of their time devoted to geriatric patients. Another 20% reported spending 60% to 80% of their time with older patients. These figures raise many more questions than are answered by the data. Are these percentages different from the amount of time family physicians with other types of CAQs spend in their practices? Are family physician geriatricians a different “breed” than those who practice across a broader age spectrum? How is the “silver tsunami” affecting decisions of physicians with geriatric CAQs regarding the allocation of time within their practice? Could it be that many family physician geriatricians are simply getting older and seeing their practice age with them? Perhaps most controversial is whether this degree of “specialization” is inherently harmful to the discipline of family medicine.
My analysis of these questions is strongly influenced by my personal journey in family medicine and geriatrics. I am an “early adopter.” I saw family practice (the term used in those days) as the natural counterpart to my 1960s-era nonconformity. I graduated high school in 1967, the same year Gayle Stephens was starting one of the first family practice residencies, and I read voraciously the writings of Dr. Stephens and Ian McWhinney. I was (and am) passionate about the family as a unit of care and the psychosocial approach. ....繼續閱讀