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We are looking for a second fellowship-trained Geriatrician to join our amazing rural Upstate New York community.
Supplements & Special Projects
Medicare Update
Medicare Gets Tough
Medicare is getting a little tougher in 2007 in several ways. This new 2007 Medicare will be likely to make a difficult situation worse for geriatric care providers and older persons alike. This year may not be an isolated rough patch; rather, it may be the beginning of a much longer period of increasing cost sharing, as well as pressure being applied to both older persons and to their providers in the form of higher premiums and deductibles for individuals—and lower reimbursement for providers. These issues could come together to force both older persons and their providers into a market ou
Filling the Donut Hole
Before the new plan year starts on January 1, marking once again the beginning of the prescription drug benefit cycle, many Medicare beneficiaries will find themselves having a difficult time obtaining their medications because of the gap in coverage. This gap in coverage, commonly referred to as the “donut hole,” is the period in the Medicare Part D benefit when the beneficiaries are completely responsible for the cost of their medications.
While many long-term care (LTC) residents are not subject to the donut hole, a fair number of them unfortunately are. The Kaiser Family Foundation
Preventing Medication Errors
More than 1.5 million Americans are injured every year by drug errors in various settings, including nursing homes. The Institute of Medicine (IOM), in its most recent report, evaluated medication errors in a broad range of settings, and finding tremendous room for improvement.1 In the report, the IOM states that at least one-quarter of all medication-related injuries are preventable. Gurwitz et al2,3estimated that 800,000 preventable medication-related injuries occur annually in nursing homes across the country.
Most of the “medication errors” in long-term care (
Freedom of Speech
Imagine a physician diagnosing a frail senior patient with hypercholesterolemia, but instead of writing a prescription for the most appropriate statin for that specific patient, the physician is forced to give a list of all available treatment options—and let the patient make a decision on his or her own. Of course, no one knowledgeable about the healthcare system would ever allow this situation to develop. This decision would be too difficult for any patient to make, let alone a nursing home resident suffering some level of dementia, yet this is the situation that the Centers for Medicare &
Who Controls the Prescription?
As physicians, we have been taught that our job is to make the correct diagnosis and then write the right prescription, assuming that our prescription would be filled. Enter Medicare Part D with its aim to increase access to medications for seniors. But has this actually occurred? A recently completed survey showed that 94% of physicians are confused about Medicare Part D, especially with regard to accessing specific prescriptions.1 This difficulty has resulted in 70% of physicians spending at least 20% more time on administrative tasks related to Medicare Part D.1 Clearly, Medicare Part D has
Clinical Geriatrics Blogs
Coming in Future Issues of Clinical Geriatrics
Series: Diabetes in the Elderly
Series: Cancer in Older Adults
First Report® Conference Coverage: American Academy of Neurology, American Diabetes Association, 2010 Digestive Disease Week
Assessment and Classification of Pain in the Elderly Patient
Pharmacologic Management of Pain in Older Patients
Miscellaneous Pain Syndromes in Older Adults
Nonhernia Causes of Inguinal Pain in the Elderly
