This week I have the pleasure of chatting with Dr. Evelyn Granieri, the chief of geriatrics at Columbia University and the NY Presbyterian Allen Hospital.
Dr. Neuberg: Evelyn, what drew you to geriatrics?
Dr. Granieri: So many things inspired me, Gerry. I loved being around my grandmothers and their friends when I was a child, and I appreciated the richness of their lives. When I was in medical school, I found myself drawn to the problems that were more common in older adults, and again was so taken by the life experiences of my patients. I also appreciated that geriatrics has its own body of special knowledge, demands complex thinking and is a team practice that relies on the skills of many professionals; nurse practitioners, social workers, therapists and others. For older adults with multiple medical and psychosocial issues, it is so important to know as much as possible about these problems and to truly care, because they are so vulnerable.
Dr. Neuberg: Please explain the difference between geriatrics and internal medicine.
Dr. Granieri: Geriatricians train as internists or as family medicine physicians and then, to become certified, we train up to three additional years to learn the complexities of care of frailer, older adults. Just because a doctor cares for old people does not mean that he or she is a geriatrician. We also focus on frailer elders who may have issues with memory, function and multiple medications. We have a comprehensive, interdisciplinary approach to their care. In our practice, we only see adults over the age of 70 who have multiple medical and psychosocial issues including dementia. These are problems that general internists and family medicine physicians may not have the resources to address. We can see patients either in consultation or for primary care.
Dr. Neuberg: House calls have become rare, but you and your trainees do home visits on patients from your office practice. Tell us about that.