The Journal of the Arkansas Medical Society Med Journal Dec 2019 | Page 8

by CASEY L. PENN
Geriatrics: A Challenging and
Rewarding Subspecialty
I
“
think a lot of people aren’t interested
in older folks, but it’s a treat to me to
care for them and honor them,” said
Demographics on Aging
Geriatrician Homer Brooks, MD, touching » » Nearly 10,000 people turn 65 every day.
on his interest in elderly patients. Dr. Brooks » » People 75 and older use 3-4x more hospital days than
people 45-55 years old.
currently practices at NEA Baptist in Jonesboro
and is among a relatively small-but-growing
number of fellowship-trained geriatricians here
in Arkansas. “Every day, I’m able to stand up for
an older person and show that little bit of re-
spect for their age and wisdom.”
Internist Holly Jennings, MD, treats geriatric
patients at Adult Medicine Specialists, a clinic
within the Baptist Health system in Fort Smith.
While her practice isn’t dedicated solely to geri-
atrics, she has acquired a large geriatric patient
population in her 25 years of community-based
practice. “Most people come to me at age 45-
50, but now they’re 70-75 years old. I still take
adults of any age, but because of the difficulties
older adults have navigating the health care sys-
tem, I often accept them preferentially.”
» » People 85 and older spend about 5x more on health
care than people 45-55 years old.
» » 25% of Medicare expenditure in last year of life – half
of this in last 60 days.
all physicians (regardless of specialty) to under-
stand how to better care for older patients. “We
have an increasing geriatric population,” said
Dr. Mendiratta. “Geriatricians alone in any state
cannot take care of all of them.”
The American Geriatrics Soci-
In 2018, there were 7,298
ety recommends collaboration be-
certified geriatricians in the U.S.
tween medical specialties to help
(americangeriatrics.org). According
strengthen geriatrics training for all
to UAMS Associate Professor Priya
physicians. With this in mind, below
Mendiratta, MD, MPH, AGSF, CMD,
is a snapshot of the geriatric spe-
the number of fellowship-trained
cialty, including a brief overview,
geriatricians trained and practicing
geriatric-patient challenges, and
in Arkansas is around 30. “Of these,
trials and rewards that go along
three are practicing primarily in
with helping patients who, said Dr.
Priya Mendiratta, MD
other fields, while 27 have stayed in
Brooks reverentially, are “walking
state to practice geriatrics,” she said. Dr. Mendi- history books.” (Also, see our sidebar on the
ratta directs the geriatric clerkship and course- challenges of community-based, small-prac-
work at Donald W. Reynolds Institute on Aging. tice geriatrics.)
The Institute addresses the needs of an aging
generation and is part of the UAMS Centers on Geriatrics – An Overview
Aging network across the state.
The American Medical Association defines
Given the projected growth of the U.S.
population aged 65 and older, it’s important for
geriatrics as the practice of physicians “who
have special knowledge of the aging process
128 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY
and special skills in the diagnostic, therapeutic,
preventive and rehabilitative aspects of illness in
the elderly.”
The specialty offers diverse career choices
and a high rate of professional satisfaction,
but demand far exceeds supply. According to a
2018 U.S. Census Bureau report, by 2035 “there
will be 78 million people 65 years and old-
er compared to 76.4 million under the age of
18 and the elderly population will outnumber
children for the first time in America’s history.”
There are no strict rules about when a
patient needs to start seeing a geriatrician as
opposed to a general practitioner. Typically, a
geriatric practice will focus on topics that are
an expected part of life for the elderly and their
caregivers. These include dementia, depression,
chronic pain associated with aging, medication
review and dosage adjustments, osteoporosis,
Parkinson’s disease, sleep disorders, cardiovas-
cular, vaccinations, fall prevention, and home
health care oversight. “There are some 65-year-
olds that need to see me, and some 95-year-olds
that don’t need to see me,” explained Dr. Brooks.
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