Healthcare Archive

Be skeptical and get the big picture from multiple sources.

When you need to find a hospital or medical center to have non-emergency surgery or a diagnostic procedure, you often have a choice—assuming you clear it with your insurance provider. How do you figure out the best place to go?

Q. My doctor, an internist, just retired, and my health plan is asking me to designate a new primary care physician. I'm 75. Would there be advantages to choosing a geriatrician as my new doctor?

A. First, a disclaimer: I am a geriatrician. So my short answer is, "Yes, of course!" But my reasoned, unbiased answer would be, "It depends." If you are a generally healthy 75-year-old woman, a family physician or internist will be able to take excellent care of you. Geriatricians are trained to care for older adults with complex illnesses and are expert in managing the care of people who are frail. Improving your ability to function, and the quality of your life, are the guiding principles of geriatric medicine. We are expert at managing complexity and uncertainty, working with families, and caring for people with serious illnesses who are approaching the end of life. A geriatrician would be a good choice if you have physical or cognitive impairment, if you take a lot of medications, or if your friends and family are involved in your medical care. For people who have several medical problems, we emphasize the role of patient and family preference in making medical decisions, with the patient's goals as our primary focus.

You need to meet strict criteria, get proper counseling on pros and cons, and be tested at a qualified center.