Geriatric Consultative Models in Primary Care

Abstract

At a time of a growing senior population, changing payment structures, and increasingly complex chronic care, comanagement models that include geriatric consultants offer an underutilized tool to keep older patients out of acute care settings. Many specialties, including orthopedics and cardiology, already work alongside geriatric specialists to create robust circles of care to minimize perioperative complications and heart failure exacerbations. Despite evidence showing its effectiveness, primary care has been slow to adopt this model and many geriatricians practice as primary care physicians. This may not be the optimal method to utilize these scarce specialists. I argue that geriatric subspecialists can play a unique and important role in not only helping other physicians manage complex, frail, and often very work-intensive patients, but assisting those patients in navigating the increasingly complex world of chronic care medicine. The geriatric co-management model is a cost-effective chronic care management system helping to prevent readmissions/hospitalizations, and delaying the need to live in a care facility for as long as possible.