My longtime patient Brenda let the top of her exam gown drop to her waist, stepped down off the exam table and turned to look at herself in the mirror. As I watched, she cupped her seventy-eight-year-old breasts in her palms and unceremoniously hoisted them up to where they'd probably resided when she was in her twenties. "I'm thinking about having my boobs done," she said. "My girlfriend had hers done, ...

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Joe had one of the best geriatricians in the city.  So when he got a call from the pharmacist saying his new prescription was ready, he assumed that it had to do with his recent annual visit and blood draw. His suspicions were confirmed, a few minutes later, when he got through to the nurse at the office. Joe was politely informed that he had high cholesterol and was being put ...

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Patricia Bach, a geriatric psychology colleague who is active in social media, recently emailed me a question: How to encourage more clinicians in geriatrics and long-term care to use social media? In particular, she asked me “What do you feel is the ROI for geriatricians to use social media/networking in their professional roles?” This is an interesting question to consider. After all, we have a limited number of geriatricians available for a growing older ...

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It’s a well-known reality of health care economics that Americans spend a lot of money in the last year of life. I suppose that almost goes without saying, since serious illnesses and injuries that result in death are costly, at whatever age they occur. Being hit by a car and dying means you were hit by a car … in your last year of life. And that two weeks in ...

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In his post, "The geriatrician shortage: The problem isn’t what you think," I completely agree that the current gap in health care professionals’ skills to care well for our aging population is exceedingly complex, reaching well beyond lack of medical school training or funding.  Funding for graduate medical education needs to be transformed to match the workforce needs of the nation, with special attention to filling workforce ...

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I’ve read several articles recently reporting on a shortage of geriatricians. The writers have some clear misunderstandings of who actually cares for our elderly and where they come from. Susan Jaffe writing for Kaiser Health News stated that the American Geriatrics Society (AGS) estimates that the nation will require 30,000 geriatricians by 2030 to serve our aging population. This is probably true, what the AGS believes. She goes on ...

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It was a little game we played. My shoes squeaked quietly down the hallway of the nursing home as I approached her room.  I knocked gently trying to avoid any particular rhythm or dissonance. Go away! Her voice was at once stern, and then followed by peels of laughter.  She only saved such greetings for me.  And I tried to trip her up.  I varied my visits by time and pattern.  Sometimes I ...

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Dear patients, This is a hard letter to write, but it is important that you know about a major change that is coming for both of us in 2017, just a short year away. As you recall, last year I left a large hospital group practice and opened my own office, and I want to thank you for your faithfulness in following me to my new location.  With the newfound freedom of ...

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shutterstock_90932108 asco-logo I have written about the support that a partner/spouse provides to someone living with cancer -- with prostate cancer and for young adults with cancer -- and I always include the partner in discussions about treatment choice or sexual difficulties. But a number of my older patients are single, and their experiences ...

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I have previously written about a patient on this site: “How elderly patients can be stubborn to their own detriment.” In that post, I discussed how the patient repeatedly turned down appropriate therapy for her hypertension, saying she didn’t need the help.  Now I’m writing an update. Due to the patient’s refusal to accept treatment for her hypertension, despite counseling on the part of her cardiologist and primary care physician that ...

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