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Old 03-01-2017, 05:58 AM
 
Location: Dallas, TX and Las Vegas, NV
5,700 posts, read 4,429,448 times
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We moved from our big house to an urban condo a couple of years ago, and now we are moving again so once again I need to find a doctor.

Last time I moved (only 15 miles away) I decided to change doctors because I had kind of been thinking of making a change anyway. I loved my old MD, but it was often over an hour's wait to see her. Although I had long ago accepted the wait, her office was about a mile from my old residence and I would walk there and bring along my ipad. Once I had to drive, I decided to make a change and found a geriatric specialist at the new location. I only went to the new doctor one time so have no real ability to compare.

But, now on to the new location......... I find there are few "Geriatric" general MD's in the area. I can find some, but it will be a 30-45 min drive. I do like the idea of seeing a doctor familiar with all the aging issues and focused on them. However, I am not a big fan of long drives in urban areas.


Soooo......do you think its worth it?
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Old 03-01-2017, 06:54 AM
 
Location: R.I.
980 posts, read 607,104 times
Reputation: 4258
Quote:
Originally Posted by WorldKlas View Post
We moved from our big house to an urban condo a couple of years ago, and now we are moving again so once again I need to find a doctor.

Last time I moved (only 15 miles away) I decided to change doctors because I had kind of been thinking of making a change anyway. I loved my old MD, but it was often over an hour's wait to see her. Although I had long ago accepted the wait, her office was about a mile from my old residence and I would walk there and bring along my ipad. Once I had to drive, I decided to make a change and found a geriatric specialist at the new location. I only went to the new doctor one time so have no real ability to compare.

But, now on to the new location......... I find there are few "Geriatric" general MD's in the area. I can find some, but it will be a 30-45 min drive. I do like the idea of seeing a doctor familiar with all the aging issues and focused on them. However, I am not a big fan of long drives in urban areas.


Soooo......do you think its worth it?
I work with 3 geriatric specialist doctors on a fairly regular basis that are on staff at the VA Primary Care Clinic where I work. As you would expect we have a very high senior population, and with only 3 geriatric specialists on staff there is a certain criteria that a patient needs to meet to be enrolled in the clinics of these specialists. Being over 80 gets you a spot automatically, but under that age a patients needs to have identified via MOCA testing memory loss issues, a dementia diagnosis, a psychiatric diagnosis, or a neurological diagnosis such as Parkinson's Disease. Reason being that the medications prescribed to treat these issues needs a fully knowledgeable prescriber, and since there are potentially multiple other issues that do arise with these specific health issues patients additionally receive care from geriatric specialist nurses, social workers, behavioral health providers, nutritionists, and pharmacists.

Honestly, unless you do not have any of the health issues I described, a good board certified internal medical doctor should be able to meet your health care needs. I do recommend anyone regardless of age if they are an insulin dependent diabetic they should see on a regular basis an endocrinologist, and those who have or had major cardiac issues should also be followed by a cardiologist.
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Old 03-01-2017, 10:59 AM
 
Location: Lakewood OH
21,698 posts, read 23,681,631 times
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I am in the process of looking to find a doctor of geriatric medicine. I wound up in the hospital due to prescription drugs' side effects. At first they checked for all kinds of things as the cause of my symptoms but then a geriatric practitioner took a look at my records and said that someone my age should have never been given the doses that had been prescribed for me.

She was right because at a lower dosage, I was fine.

The drugs were okay, the dosage was not. The GPCP said that this was becoming more and more common with prescribed drugs for older people. I am going to find a geriatric specialist so that any time any doctor prescribes meds for me I can run it by him or her to see if the dosage is safe.

The other thing is that I think this type of doctor would be more in tune with old age medical problems.
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Old 03-01-2017, 12:24 PM
 
Location: SF Bay Area
153 posts, read 104,555 times
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If you are using them as a general practitioner as a senior adult then yes.

But it is still BEST practice to go to an actual specialist on whatever body part ails you. Such as a cardiologist for heart problems and so on.
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Old 03-01-2017, 02:14 PM
 
Location: Lakewood OH
21,698 posts, read 23,681,631 times
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Quote:
Originally Posted by Protagonista View Post
If you are using them as a general practitioner as a senior adult then yes.

But it is still BEST practice to go to an actual specialist on whatever body part ails you. Such as a cardiologist for heart problems and so on.
I don't think that would be a problem since I'm sure the geriatric general practitioner would recommend a specialist if needed just as a regular PCP would.
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Old 03-02-2017, 04:10 AM
 
Location: Los Angeles area
14,018 posts, read 17,751,136 times
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Quote:
Originally Posted by Minervah View Post
I am in the process of looking to find a doctor of geriatric medicine. I wound up in the hospital due to prescription drugs' side effects. At first they checked for all kinds of things as the cause of my symptoms but then a geriatric practitioner took a look at my records and said that someone my age should have never been given the doses that had been prescribed for me.

She was right because at a lower dosage, I was fine.

The drugs were okay, the dosage was not. The GPCP said that this was becoming more and more common with prescribed drugs for older people. I am going to find a geriatric specialist so that any time any doctor prescribes meds for me I can run it by him or her to see if the dosage is safe.

The other thing is that I think this type of doctor would be more in tune with old age medical problems.
What a shame you had to find out the hard way about the drug dosage levels. But at least your story had a happy ending. One would think that the prescribing information would include dosage levels for people over the age of X if that is indicated. But no, the world is the way it is - very imperfect.
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Old 03-02-2017, 11:16 AM
 
Location: Somewhere in deep in Maine
3,664 posts, read 2,814,601 times
Reputation: 4436
Where I retired, there are no old people doctors. Its not an issue. In fact, I'm not sure I ever lived anywhere where there were old people doctors unless they were more of the test, test, test and give pills variety. My wife is currently wearing a month long heart monitor because her GYN scared her into it because she was experiencing a racing heartbeat at night.

I had already diagnosed the problem for her and fixed it for her. Her doctor never asked her anything about her food or her lifestyle. She has normally low blood pressure(about 90/60 to 100/70). So she was drinking a glass of wine in the evening, and this dehydrated her since she wasn't drinking any other fluid, as well as lowering her BP further. Then she would go to bed under a heavy comforter and get very very overheated in bed. She is a heavy sleeper, so she wouldn't wake up until her heart was racing at 140 BPM trying to cool her down with a lowered BP, dehydration, and overheated-ness.

So I told her to stop drinking wine unless she drinks 4 glasses of water to go with it, increasing her fluid to 16 oz before bed, and taking off the heavy comforter and keeping our sleeping quarters at about 60 degrees. Since she has followed my instructions, she has not had any racing heartbeat at night that wakes her up or any racing heartbeat at all.

I'm sure the doctor would be ready to put her on some kind of pills or something. The doctor did no real diagnosis and only looked for some kind of technology.
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Old 03-02-2017, 11:20 AM
 
Location: Central Texas
20,423 posts, read 37,832,578 times
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My new doctor is certified in family practice/geriatrics. At 67, that's a perfect fit for me, and she's very thorough. She also refers to specialists when appropriate, and considers me a partner in my own health care, a major requirement in a doctor for me.
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Old 03-02-2017, 11:33 AM
 
Location: ☀️ SWFL ⛱ 🌴
2,436 posts, read 1,673,946 times
Reputation: 8716
Quote:
Originally Posted by Escort Rider View Post
What a shame you had to find out the hard way about the drug dosage levels. But at least your story had a happy ending. One would think that the prescribing information would include dosage levels for people over the age of X if that is indicated. But no, the world is the way it is - very imperfect.
It's just been in the recent decade or so that different dosages in medications based on age has come to light.

Drugs can stay in the body longer making dosage more complicated for older people. At work (diagnostic imaging) it was protocol to test anyone over sixty for renal function before injecting contact material.

https://www.uptodate.com/contents/dr...r-older-adults
Particular care must be taken in determining drug doses when prescribing for older adults. An increased volume of distribution may result from the proportional increase in body fat relative to skeletal muscle with aging. Decreased drug clearance may result from the natural decline in renal function with age, even in the absence of renal disease. Larger drug storage reservoirs and decreased clearance prolong drug half-lives and lead to increased plasma drug concentrations in older people.
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Old 03-02-2017, 11:48 AM
 
Location: Lakewood OH
21,698 posts, read 23,681,631 times
Reputation: 35449
Quote:
Originally Posted by jean_ji View Post
It's just been in the recent decade or so that different dosages in medications based on age has come to light.

Drugs can stay in the body longer making dosage more complicated for older people. At work we tested everyone over sixty for renal function before injectting contact material.

https://www.uptodate.com/contents/dr...r-older-adults
Particular care must be taken in determining drug doses when prescribing for older adults. An increased volume of distribution may result from the proportional increase in body fat relative to skeletal muscle with aging. Decreased drug clearance may result from the natural decline in renal function with age, even in the absence of renal disease. Larger drug storage reservoirs and decreased clearance prolong drug half-lives and lead to increased plasma drug concentrations in older people.
That's what I discovered in my research about the subject. Although for years there have been warnings prescription drug labels regarding the safety and dosages for children, there has been nothing about how the regular dosage might effect older people whose systems may not be able to handle a "normal" dose. This is something new being looked at and doctors should be paying attention but unfortunately many are not.
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