The Valuable Role of Geriatricians


Barney S. Spivack, MD, FACP, CMD,
Associate Physician Editor,
Clinical Geriatrics


Pages 13 - 14

Geriatric medicine has clearly come of age within the past 20 years. Not only have the research insights, care approaches, and clinical skills been promoted within different practice environments but also very innovative approaches to the care of older persons have been developed. We can point to the increasing prominence of geriatric medicine as a discipline, but our patients, their families, and our colleagues would all benefit from a clearer identification of our potential role in the care of older adults. How many of us have been asked, “What does a geriatrician do?” and “At what point should an older adult see a geriatrician?”

I believe the recognition of our value and potential role would become much clearer if we were able to recruit adequate numbers of new physicians to our discipline, and to work more collaboratively with our physician and health professional societies and other organized professional groups. This would promote greater visibility both within the general medical community and with the public. The AGS Foundation for Health in Aging (FHA) has laid the groundwork for this effort by promoting public and professional partnerships around issues affecting both older adults and our ability to deliver high-quality professional care for them.

A primary reason identified for the lack of appropriate numbers of geriatricians has been an economic one—inadequate reimbursement for the services we provide. The core elements of good geriatric care include appropriate assessment and coordination, preventive programs within the community, and adequate long-term care and chronic care services, and we continue to seek adequate reimbursement for these critical services. The AGS is a vigorous and key leader in this area and has achieved a growing recognition for its public policy initiatives. A significant part of its focus has been on ensuring that the practice of geriatric medicine—whether by geriatricians or by other physicians with skill and expertise in the care of older adults—remains viable, professionally satisfying, and focused on high-quality care.

For example, in continuing to advocate for a new fee-for-service benefit from the Centers for Medicare and Medicaid Services (CMS), the AGS was successful in 2004 in lobbying for a physician care management demonstration project, as a first step, within the Medicare Modernization Act (MMA). The essential role of the physician in any disease management program was highlighted by the AGS, and we will continue to follow these developments closely.

As you have read previously in this column, your local AGS affiliate can and has taken a leadership role in promoting legislative initiatives that will improve the care of older adults as well as our ability professionally to provide this cost-effective and high-quality care. Just a few months ago, the President of the California Geriatrics Society (CAGS), Dr. Moira Fordyce, met with staff members of her state congressional delegation as well as the White House Conference on Aging. These meetings were made possible through the AGS Policy Grassroots Program Award, given to the CAGS in recognition of past advocacy efforts. One of the senators Dr. Fordyce met with, Senator Barbara Boxer (D-CA), agreed to co-sponsor the Geriatric and Chronic Care Management Act (our top legislative priority) as a direct result of this meeting and joined more than a dozen other senators in doing so. Other state AGS affiliates have also been active in promoting our legislative priorities—both locally and nationally—and also have success stories to share.

We urge you to become more involved in your state AGS affiliate, as well as in the AGS national organization, in order to move forward the issues that clearly impact our profession and our patients. For more information about the AGS affiliates or for assistance in organizing an affiliate in your area, please contact Deirdre Terry, AGS Senior Membership Manager, at, or write to me at I look forward to hearing from you and working with you to secure a strong future for geriatric medicine.