Geriatrics as a specialty--problems and prospects

Geriatrics in family practice. A comparison of data from Wisconsin and Virginia

For 109 Wisconsin family practices, 18% of all contacts were with patients 65 years of age and older. Of these contacts, 45% took place in the office and 40% in the hospital; the patient was female in 58.7%. The number of problems or diagnoses was 2.28 per patient contact. Comparison of the geriatric problem profile from the Wisconsin study with similar data from Virginia showed striking similarity. The diagnostic category "diseases of the circulatory system" contained more than 30% of patient problems. No other category contained 10% or more problems in either study. The problem profiles for men and women were almost identical, suggesting little difference in medical care needs according to sex.

Gerontologic and geriatric training in medical school: curricular preferences shown by medical students, educators, and general practitioners

The need for incorporating gerontologic and geriatric training into the education of medical students is evident. Two main obstacles are the lack of educator knowledge in planning such training, and negative attitudes toward aging and the aged. Curriculum planning requires a design for the goals/objectives, the content, and the delivery vehicles. This article concerns chiefly the delivery vehicles, a subject which has received little attention in the literature. Negative attitudes on the part of students and their educators may defeat the incorporation of geriatric training into the curriculum. To assist in reducing these obstacles, a study was conducted for the purpose of providing data to educators which might facilitate the design of a delivery component for a medical student curriculum in gerontology and geriatrics. Senior medical students, their educators, and some general practitioners were surveyed in randomized groups, to determine: 1) their preferences for delivery vehicles in such a curriculum, 2) their attitudes toward aging and the aged, and 3) relevant demographic variables. The results are discussed from the viewpoint of the potential impact of these factors on their preferences and on the creation of obstacles to curriculum incorporation.

Medical direction in long-term care

This report presents the views of over 1000 administrators, nurses and physicians with respect to the responsibilities, authority and impact of the medical director in a long-term care facility (LTCF), as well as the nature and future of long-term care and geriatric medicine in the USA. Nurses, administrators and physicians were more able to agree on the bureaucratic functions of the medical director than on the functions which might be considered more clinical or activist in terms of the total needs of the LTCF. There was no consensus about the external factors which might determine the future of LTC, i.e. alternatives to institutionalization, public attitudes or community hospital relations. Instead, concern seemed to focus upon the "low level" of funding for LTC. With respect to the nature of LTC itself, most respondents felt that the area was clinically challenging. However, only 40 percent of the physicians believed that clinical skills were more important than a sympathetic regard for patients. As a corollary, physicians were the least supportive of geriatrics as a new specialty in medicine.