Seeing Around Life's Corners: The Power of Geriatric Consultations

Do you remember playing with periscopes as a kid? There was nothing quite like the thrill of being able to see around corners and anticipate what was coming.

That ability to foresee events, I believe, is the hallmark of highly accomplished people, whether in chess, business, or other fields. Those with foresight are the ones we tend to put on pedestals.

For this very reason, I believe it’s time we put geriatricians on pedestals. And also for this very reason, I believe that every person over the age of 65 should have at least one consultation visit with a geriatrician.

I realize this is a fairly radical proposition, especially since we’re trained as a society to deny the signs of aging. But I believe there’s a solid case to be made.

First off, for the many people who aren’t deeply familiar with the field of geriatrics, the discipline only gained its first official fellowship in the U.S. in the 1980s, and there are currently fewer than 7,500 geriatricians nationwide, compared to roughly 67,000 pediatricians.

As I discussed in an earlier post touting the virtues of geriatric care, there’s an obvious difference between the fields of pediatrics and geriatrics – namely, while all children need a pediatrician, not all seniors believe they need a geriatrician. The American Geriatrics Society says around 30 percent of seniors – nearly 17 million people – need geriatric care to effectively manage their chronic illnesses.

The problem for the other 70 percent of healthy seniors: we often don’t know we’re on a path to a chronic illness, or cognitive or functional impairment until the signs are directly in front of us. 

Enter my idea of geriatric consults for 65-year-olds.

Unlike typical primary care practitioners, geriatricians are experts on how aging affects one’s physical and emotional health, and the ways we can head off problems on both fronts. Just 7 percent of seniors are screened by their doctors for key geriatric issues, and fewer than a third have been asked by their doctor if they’ve had a fall – which, as those of us in the industry know, can be the start of a significant decline for a senior if not managed properly.

Generalists simply aren’t trained extensively in the science of geriatrics, and in a clinic filled with younger people, they don’t have the opportunity to develop this expertise on their own.

To my knowledge, there’s not yet been a study to conclusively prove the following, but I will put money on it: if I gathered a big room full of 65-year-olds and sat each of them down for one hour with a skilled geriatrician, I am confident that the group’s quality of life over the next 20 years would outpace that of a control group with no geriatric consult.

That’s because a skilled geriatrician would, after an in-depth evaluation, be able to offer each patient a glimpse into key health vulnerabilities any given senior could anticipate (and thus more quickly address) when the earliest symptoms appeared. And in some cases, the geriatrician’s recommendations might even head off such symptoms.

After all, they’re trained to see around life’s corners.

If this is indeed the case – why are geriatric consultations not common among seniors today? 

Two reasons. First, general practitioners themselves often don’t know enough about the value of geriatric care to recommend such specialists to patients who are turning 65. But second, and just as importantly, patients themselves aren’t trained to look for such care as they age.

Much to the contrary, in fact: people often recoil when they hear the suggestion that they’d do well to consult a geriatrician. To overcome this stigma, we should think of geriatric consults as we do financial planning. Just as we prepare financially for retirement, we should prepare for our health in our later years.

Fortunately, there are a growing number of healthcare companies focused on the 65+ population, thanks partly to the fact that older Baby Boomers represent a massive business opportunity for healthcare investors. Hopefully, as this market grows and we all advertise our services more broadly, the cumulative impact of those messages will diminish the stigma of geriatric care.

Welcome Health is a business too, of course, and financial success is critical for us to continue our mission. But serving seniors is far more than a money-making strategy for us: it is our mission to make geriatric care to seniors what pediatric care is for children – namely, something so normal, so typical, that it’s like the air we breathe.

We hope you’ll join us on that quest, even if you’re not in the age group we serve. With luck by your side, one day you will be in the 65+ cohort, and when you do get there, we will hopefully be by your side too.