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Family Physician the New Healthcare Star

Posted Jun 15 2012 9:00am



The proportion of Americans 65 and older is projected to increase from 12 percent in 2005 to 20 percent by 2030, according to Family Physicians' Present and Future Role in Caring for Older Patients , which was produced by the American Academy of Family Physician's Robert Graham Center for Policy Studies in Family Medicine and Primary Care.

No surprise:
  • Family physicians often are the key caregivers for geriatric patients.
  • They are caring for more geriatric patients. That care presents both opportunities and challenges.
    The shortage of family physicians in the United States is documented. There are even fewer physicians certified in geriatric care, just 7,162 certified geriatricians in the United States.
    The combination of payment and treatment challenges tends to discourage physicians, residents and medical students from pursuing further training in geriatric care. But adoption of innovative care and delivery models, such as the patient-centered medical home (PCMH) could make it easier for family physicians to meet the needs of their older patients by focusing more on care management and care coordination.

    Interestingly, the company we launched in New York, Touchstone Health, had just this model and some 10 years before it was fashionable. We had our own medical director in place and did intense medical management for the senior population. That meant a focus on wellness and prevention, fewer hospitalizations and better coordination. That saved medical costs and also helped the company earn money too. Back then they were affiliated with a Medicare+ Choice plan. Now they have their own Medicare Advantage offering. In fact Medicare Advantage I believe is a precursor to the medical home concept of today.

    Still, work is needed. According to a recent poll from the John A. Hartford Foundation , many patients over 65 aren't getting the recommended interventions to maintain their health, Kaiser Health News reported. In particular, the results, which cover a 12-month period, revealed the following shortcomings in seniors' care.
  • One-third of older adults said doctors didn't review all their medications.
     
  • More than two-thirds of the time, health providers didn't conduct a fall-risk assessment or history for older patients.
     
  • 62 percent of seniors surveyed said they were not screened for depression.

  • All are part of Medicare's annual wellness visit, though more than half of the patients surveyed by the foundation had never heard of the no-cost benefit. As you plan your healthcare going forward don’t get too bogged down in medical terms like medical homes. Do look for a practice that will help you maintain your health and quality of life, coordinate your care and one which is becoming more sensitive to the needs of an aging population by employing certified geriatricians.  And you may want to look at Medicare Advantage as one model of care for this. It may take some time for traditional practices to catch up. 
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