Skip to comments.As Tampa Bay population ages, few doctors want to specialize in geriatrics
Posted on 11/26/2012 2:55:29 AM PST by Cincinatus' Wife
TAMPA Dr. Inna Sheyner cupped her hand to speak into the ear of her 91-year-old patient, pledging loudly to answer all his questions about his constellation of problems, from heart failure to constipation, requiring a dozen medications.
"The problem is, you're not taking half of that list," she gently scolded Everett Haehnel. "You know that, and I know that."
He promised to do better. Sheyner offered to have a pharmacist help him, and put in orders for a physical therapy session at his Sun City Center home and a consult for dementia.
Two University of South Florida medical students scribbled notes vigorously. But neither wants to follow Sheyner into a specialty that cares for the oldest, most complicated patients.
Anyway, they can't locally.
Geriatricians are in alarmingly short supply, yet USF closed its geriatrics fellowship last year due to lack of interest. While other Florida schools are hanging on, they aren't training anywhere near as many geriatricians as are needed.
Yet experts think more geriatricians like Sheyner could be the key to fixing a health care system that spends too much on too many doctors, drugs and surgeries for frail seniors who don't benefit and may even be harmed by excessive care.
"We are entering into a new era of medicine where the role of a geriatrician could be very important to a health care system," said Dr. Ken Brummel-Smith, chairman of the geriatrics department at the Florida State University medical school. "You will have doctors who need to be expert in increasing quality while decreasing cost that's where geriatricians shine."
(Excerpt) Read more at tampabay.com ...
Good. Maybe the play times will get shorter on Florida golf courses.
The Leftists have learned from Social Security—old people must die sooner to keep the system solvent—the Feds have no power to kill off grannies on social security but with Obamacare they do.
Old people — gumming up the works.
People with cancer — wanting too many screenings and treatments!
These are the things that children used to do for their parents in the good old days. Parents took care of their children when they were young. Children took care of their parents when they were old.
Now they go live in a retirement village and expect the government to take care of their health needs.
That will not last much longer.
The more that can be dispatched on the front end (abortion) and on the back end (those not pulling their taxing weight being moved off or shamed into taking their leave ASAP) will be welcome news to Obamacare’s bottom line.
Going to Sun City is like entering the Twilight Zone. Very few people are younger then 70.
Good palliative care will be a blessing.
What you will probably get is a too large bottle of Vicoden ( a subtle hint ) and a stool softener.
No need for Geriatricians, just take the pill.
50 years ago it was rare to see family’s taking care of late 80- 90 year olds. There weren’t that many around. And if they were, they weren’t taking 3 pages of medications and having numerous operations that were keeping them alive past their natural expiration time.
Oh geez, Obama's plan was born from a movie!
Docs don't even get 50 cents on the dollar from medicare now.
Of course not. Who wants to be underpaid by Medicare, even after jumping through their compliance hoops?
I am surprised the elderly can find anybody to take them.
Add to that the work environment where the doctor knows he/she can’t cure “old age”.
The idealized view of “having Granny in the home” was more likely to be one of her in her rocker, helping out with the grandchildren and watching the pots on the stove.
Very few of our colonial ancestors were changing diapers and running back and forth to doctors/hospitals.
I think that geriatrics is a PERFECT place for the new group of PA’s and nurse practitioners to thrive. I’m no doctor, but it seems that medication management, chronic illness, post-op followup, etc. is a good place for these individuals, and a lot of money could be saved as well as more time per patient given.
You make a good point. I would also mention that back in the day, for the most part at least, not as many women worked outside of the home and so some had the time to take care of their infirmed elderly parents, but thats not to say that this was an easy job.
My mothers aunts husband suffered an on the job injury that left him paralyzed below the waste and later he suffered a debilitating stroke and was cared for at home until he died at around the age of 45.
Back then there was no workers comp or insurance or Medicare or SSA, in home therapy, but my great aunt managed to take care of him and their two young boys with the help of my grandmother and my mother who lived with her after my grandfather died at an early age (40 something) from a sudden massive heart attack. But my great aunt ended up going to work full time as a bookkeeper just to make ends meet for this extended household. And my grandmother took in laundry and cleaned houses for their more well off neighbors while helping to care for her BIL and the kids. My mother dropped out of high school in the 11th grade to get a job in a candy store because during the depression, a job was hard to come by and very much needed and more important than a high school diploma.
As a little kid, I remember my great aunt Serene was one tough cookie, loving and kind but very tough, she a very tough outer shell, a rather stern personality sometimes¸ but then she needed one to get through those very tough times.
This article assumes that specialties like geriatrics and neonatology will even exist in 5 years. Don’t think oncology has much of a future either. The biggest mistake the Affordable Care Act makes is that Doctors intend to stay in practice; a practice designed by the Government. Remember boys and girls, ObamaCare = Cost Savings = NO CARE
Few doctors want to be part of the Medicare/medicaid system, which pays less and less every year. They just took another massive pay cut this year and ObamaCare cuts that even further.
My grandmother, on the other hand, lived independently into her late 70s. She was a very strong and very difficult woman. She lost most of her eyesight due to macular degeneration in her 80s. I'm sure her 60 year chain smoking habit didn't help. As she entered her 90s my father and aunt sent her into a nursing home because she developed dementia and needed round the clock care.
It would have been physically impossible for her 70 year old “children”, who had their own health problems, to take care of their mother.
My MIL similarly lived alone and I used to go to her house to take care of her several times a week for several hours at a time while working a full time job (neither my now ex-husband nor his sister nor her grandchildren wanted to deal with her or the increasingly difficult and dangerous problem, pretended that everything was just fine, so her care was pretty much left to me). Evelyn was IMO, well past the point of taking care of herself anymore and was similarly delusional. She also had developed an aversion to bathing or using the bathroom, preferring to piss and shat herself where she sat and clean up with tissues that she stuffed into the sofa cushions and most days refused to eat anything even when I cooked for her she was skeletal in appearance and she and her house stank to high heaven despite my best efforts to keep it clean, doing her foul laundry and getting her into the shower and into a clean night gown. I recall the epic fights trying to get her to bathe.
It started with me sitting with her and talking and watching TV for a while when Id casually mention You know Evelyn, this would be a good day to take a shower after a shower I can make you Dinty More Beef stew and cheese and Ritz crackers (one of the few things she would eat if I made them for her). Then Evelyn would curse at me like a druken sailor, shake her cane at me, and threaten to throw things at me, she actually stuck me a few times. So wed talk and watch TV together for a while and Id wait for her to calm down and then I suggest again, You know Evelyn, I bet youd feel better if you got a shower and changed into a clean night gown and this could go on for hours until I finally broke her will and got her bathed.
I kept telling my husband and SIL that their mother should not be living alone but it wasnt until she was admitted to the hospital for stomach pains that ended up with gall batter surgery that a hospital social worker finally convinced my husband and his sister, after I told the social worker about her living conditions, that Evelyn couldnt go home.
For a time my ex wanted to move her into our home but this was simply not possible with both of us working full time Evelyn really needed round the clock care and the type of nursing care that I couldnt provide and truthfully was not mentally and physically prepared to provide 24-7 even if we could have financially afforded for me to quit my job and care for her full time, especially considering that I had already figured out that I would get little or no help from my husband or her family.
After being discharged from the hospital Evelyn went to a nursing home and I visited her several times a week, continued doing her laundry and looked out for her care and comfort. But her mental and physical condition continued to deteriorate to the point she had to be put on a feeding tube and she eventually suffered a stroke that put her in a locked fetal position for the last two years of her life unaware of her surroundings, unable to communicate, living on a feeding tube. Even though she got excellent nursing and medical care, better than I expected actually, I really hope I never put my family through that sort of thing, Id much rather die from natural causes than live out the last years of my life that way.
Then they will proceed to take care of the feebleminded and those with other mental and physical defects, including children, and various other lebensunwertes Leben.
I think the main program is found in Section T4 in the Obamacare Law under the name of Gemeinnützige Stiftung für Heil- und Anstaltspflege and is administered by the newly formed Erbgesundheitsgerichte.
We needn't worry about government "waste". It is very efficient and shows quick results.
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