Busy practitioners can most effectively and efficiently care for geriatric patients by making appropriate use of physicians’ assistants, nurse practitioners, speech/language pathologists, audiologists, physical therapists and occupational therapists. “It’s important for the otolaryngologist to realize that caring for geriatric patients is a team effort and that it’s not his exclusive responsibility to rehabilitate these people but to oversee their rehabilitation,” Dr. Goldstein said.
Explore this issue:October 2012
A physician who is caring for an elderly patient with tinnitus might not only prescribe appropriate medication, but also refer the patient to a physical therapist who can provide balance therapy. Otolaryngologists who treat patients with dysphonia may perform vocal cord augmentation and refer patients for voice training; ideally, they’ll also assess the patient’s ability to communicate in daily life and work with the patient until the patient can comfortably function and interact with others.
Preparing for the Influx
Few practicing otolaryngologists received a solid medical school education in geriatrics. “The average ENT resident doesn’t get any significant training in the care of the elderly patient,” Dr. Goldstein said. Dr. Johns agreed: “When I went to medical school—and I graduated in 1996—we had absolutely no specific component of our curriculum dedicated to the care of older patients.”
Medical schools today are beginning to address that deficiency. “At Emory, we now have a specific component of our curriculum that’s dedicated to geriatric medicine, both in the foundation years and reinforced in clinical,” Dr. Johns said. “That’s a big change that is due in part to some great efforts by the American Geriatric Society and the Donald W. Reynolds Foundation, which have made a dedicated effort to improve education regarding the care of older patients.”
Physicians who did not receive specialized geriatrics education in school are well advised to pursue self-education. Professional organizations such as the American Academy of Otolaryngology and the ASGO offer a variety of conferences, online courses and tools, workshops and books to help practicing otolaryngologists better understand the needs of the geriatric population. (See “Resources on Geriatric Patients,” left.) Some states, Dr. Bhattacharyya said, now require specific CME hours in geriatric medicine.
Dr. Bhattacharyya urged practicing otolaryngologists to become familiar with geriatric otolaryngology research, particularly as it relates to their practice. “Take a look at the research involved, and make some projects for your own patient population,” Dr. Bhattacharyya said. “Make a three-year and a five-year plan. You’ve got to keep your eye on the ball, instead of waiting for the geriatric population boom to happen. It’s coming, soon.”