There is so little that is known about this entire issue. I have been proposing for years that a fortune could be made by the right enterprising person in establishing specialized medical facilities for our "geriatric" population. I know we now have geriatricians but that doesn't mean we have figured out how to best administer care to this population or how to best manage their multifaceted issues. Most people I know (personally or professionally) who are over 65 are seeing a minimum of 3 physicians and many are regularly seeing 5 or more (PMD, cardiologist, gynecologist, gastroenterologist, urologist, orthopedic...). I see a high incidence of depression and as a specialist unrelated to most of the "common" disorders, I sense a complete lack of understanding of (on the patient's part) of the purpose of their medications and (on the doctor's side) or their potential for interaction.
So I was not the slightest bit surprised to see a recent article in the NEJM that demonstrated that coordinated care for medical and psychological issues leads to better outcomes. The only surprise was that such a study need be done to prove such an obvious concept. Our health care system is truly challenged and will only become more so with the advancing age of our population-we need to find a new paradigm for treating this group of patients and to better understand the effectiveness (and thus the need) for our interventions. This must be a rallying cause for 2011!
|The best over 90 woman I have ever known-my Grandmother Frieda|