Head To Head

Should geriatric medicine remain a specialty? No

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.39533.696076.AD (Published 30 June 2008) Cite this as: BMJ 2008;337:a515
  1. C P Denaro, director, associate professor12,
  2. A Mudge, staff physician1
  1. 1Internal Medicine and Aged Care, Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
  2. 2University of Queensland, Brisbane
  1. Correspondence to: C P Denaro c.denaro{at}uq.edu.au

    The development of geriatricshas greatly improved care for older people. Leon Flicker (doi: 10.1136/bmj.39538.481273.AD) believesspecialist care remains important for this vulnerable group,butC P Denaro and A Mudge argue that age divisions are no longer relevant

    Our patients have changed. The inverted pyramid is imminent. Every developed country is facing an increase in older patients.1 2 The fastest growth in emergency admission rates is in the oldest age group.2 These changes translate into major changes in the profile of our hospital patients, as older patients with multiple chronic diseases and disabilities occupy more beds. In addition, improved survival is also leading to larger numbers of younger people with chronic disease and disabilities living in our communities.3 Thus it is not just geriatricians who have to be able to manage acute and accumulated chronic diseases and to assess and manage the functional, cognitive, and psychological impairments that can influence longevity, quality of life, use of health care, and treatment decisions.

    The concepts of comprehensive assessment, multidisciplinary care, rehabilitation, and planned discharge have been championed by many …

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