Geriatric Medicine

What makes Geriatrics, perhaps the most valuable sub specialty is that its training, research & education is focused on multiple systems, not just one system, like the heart, as in cardiology.  Geriatrics medicine embraces all systems; heart, circulatory, skin, renal, neurological, brain, memory etc. Geriatric clinical medical training teaches how all these systems are working for or working against each other in older adults.  Many older adults have chronic illness, such as Alzheimer’s, Dementia, Parkinson’s, Strokes, Heart Attacks, Depression, Anxiety, Paranoia, Urinary or Fecal Incontinence, Balance, Mobility Issues & Falls, all of which complicate the treatment plan and require a high level of coordination & continuity, if the best outcomes are to be achieved. 

In the new age of anti- aging many don’t typically think of Geriatrics, but the training, research and education is the embodiment of Geriatrics training which has a more significant focus on continuity of care and team work than other specialties and expands its assessments to include mental & emotional health, as well as non-medical or custodial care.  These are critical elements for any chronic care plan.  The nature of expanding the focus to look at the person or patient as a “whole” and not as just one system improves quality of care and creates enormous cost savings & value.  This is severely lacking in today’s health care system. 

In the early 1990’s Geriatric Medicine was a brand-new concept. That was just two decades ago.  Dr McGivney was fortunate to be a part of the first generation of Geriatric Medical Fellows at the prestigious Mount Sinai Department of Geriatrics in NYC when Geriatric fellowship and National Specialty Test and Certification first began. He saw early on in his studies the enormous need for senior care, a need that would explode by 2016 when the first baby boomer turned 70.  Fortunately, other sub specialty Fellowship Programs are starting to offer added training in Geriatrics for their respective fields.  Even, CMS Medicare is increasing requirements in Geriatric Training as part of Medical Residency Training Programs, in order for the programs to receive their educational funding from Medicare.  

Unfortunately, todays broader Health & Senior Care Systems are more insurance or finance driven and significantly undervalue the enormous benefit that Geriatric Training & Principles could have for millions of older adults who have chronic illnesses.  The current Health & Senior Care Systems have taken a different path, shifting away from Continuity of Care, rather focusing on Acute Care and Sub Specialty Care, which will continue to dramatically increasing costs and reduce Continuity of Care.  Chronic Care represents 86% of all health care spending.  It seems to make fiscal sense to focus on chronic care instead of acute care which accounts for only 14% of health care spending. 

Dr McGivney continues his to build on the training & principles he first learned as a Geriatric Fellow.   He continues to share his broad-based Geriatric and Chronic Care expertise as an educator, advocate, and community leader.  His goal is to educate as many people as possible, especially those with chronic care needs, in hopes they will have more complete and accurate information with which to make the most medically effective and cost-effective choices to be able enjoy the best quality of life. 

Dr McGivney hopes more medical professionals will begin to recognize enormous benefits gained from having the advanced knowledge, training & leadership of a Geriatrician to coordinate and provide continuity of care for older adults with chronic illnesses which in turn lead will lead to higher quality and more cost-effective care.