Doctors in any of these fields can serve as primary care physicians and have a team to serve you, however, you may want to consider finding a geriatrician. A geriatrician is a doctor who specializes in the medical, social, and psychological issues that concern people 65 and older.
Just as a pediatrician tends to the needs of a child, a geriatrician cares for the special needs of changing seniors. Geriatricians approach each patient’s needs individually and possess the knowledge and expertise needed to accommodate seniors.
- Family practitioners treat a wide range of medical problems in people of all ages.
- Internists or specialists such as cardiologists, endocrinologists, neurologists, and geriatric psychiatrists.
- Geriatricians specialize in caring for older adults.
- Doctors of Osteopathy (D.O.) often spend more time with their patients in order to provide more holistic care
Many physician practices are now owned by large hospital systems. Their billing and other services are now part of the hospital network. Due to changes in Medicare and fee for service rather than reimbursement for time spent with patients, some physicians are no longer accepting Medicare patients. If an older person has chronic medical conditions, it is advisable to find a physician specializing in geriatrics.
What to consider when choosing a doctor:
- Does the physician accept your health insurance coverage? Most physicians will accept Medicare, but it’s important to determine whether or not they will accept Medicaid and/or a supplemental policy if one is available. Check with your health insurance provider for a listing of their in-network providers.
- Is the office easy to get to? It is important to choose a doctor whose office is located close enough to be easily accessed for routine care and emergencies. If your loved one is homebound, a physician who understands this and is willing to provide care is ideal. Physicians can order home health nurses to draw blood, administer injections, take vital signs and perform other basic medical procedures, then report to the doctor if skilled services are provided in the home already.
- Can lab work or x-rays be done in the office or nearby? Most lab tests are done in the doctor’s office but some doctors prefer to send patients directly to a lab. There are also mobile labs and x-ray services that can come to the home if a person is homebound. Check that the lab you use is considered in-network with your health insurance provider.
- Physician’s office hours are convenient. Understand your physician’s office hours, weekend hours, telephone communication options, and “on-call” physician’s availability.
- Is the physician Board-certified? Board-certified doctors have extra training and pass special exams after medical school to become specialists in a field of medicine such as family practice, internal medicine, or geriatrics.
- Does the physician see many patients who are similar to your loved one? Does the physician treat many patients with the same chronic health problem that your loved one has such as diabetes, heart problems, or blood disorders?
- Is this a group practice? Choosing a doctor in a group practice provides a team of specialists with similar approaches to care, office practices, and care options.
- Where does the physician have hospital privileges? When choosing a doctor, it is important to find out which hospital the doctor is affiliated with. This is the same hospital your loved one would go to for emergency care, tests and surgeries in most cases. The size, location and reputation of the hospital may play a large role in your decision to choose or not choose a specific doctor. If your loved one has a condition that is treated by a specialty hospital, it is important to determine if the primary physician has privileges there.
Other topics to explore when establishing a new medical provider or when speaking with your current medical provider:
- Do you visit your patients in the hospital? If so, which hospital(s) do you have medical privilege in?
- You were highly recommended. How often will I have face-to-face interaction with you during my medical visits? Or, will I mostly see one of your nurse practitioners or another medical doctor within your practice?
- Upon discharge from a hospital, you should have a medical appointment with your primary care physician. Often, it can be difficult to get a medical appointment with a primary care physician within 48 hours of discharge from a hospital. What are your guidelines and policies regarding 24- 48 hours follow-up for patients who were recently discharged from a hospital?
- Who is your preferred home health agency for skilled services (physical therapy, occupational therapy, speech therapy, etc.)?
- Which nursing home facilities, assisted living facilities and independent living facilities does your physician group see patients?
- End-of-life planning/discussion is often minimized. How comfortable are you with discussing end-of-life planning with my loved one? How soon do you, as a medical provider, initiate the conversation about end-of-life planning?
- How often do you complete a medication review with your patients? (Note: Medicare pays for annual medical review). This is when your primary medical physician reviews your medications with you, and makes appropriate changes as needed. Remember, just because you have been on a specific medication for months or years does not mean that you still need that medication. As you get older, the ability of your organs that generally function to break down medications does not always function as well.
- How often do you attend continuing education to remain up to date on medical research, trends, and medications?
- How soon can I expect to hear back from you or your lead nurse regarding medical questions about my care or medication refills?
- When you are traveling or unavailable, who covers your patients? Will I be notified when you are not available in a timely manner?
- Do you have any plans of leaving your practice, or your current physician group, within the next 6 months?
- Do you have a nutritionist on staff to assist with meal management?
- How do you address polypharmacy (taking multiple medications) with your patients?
Questions courtesy of Kizzy Caldwell – Aging Life Care Professional www.rrcaremanagement.com
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