Larimer County Summit on Aging
Shaping the Future of Larimer County
Abstract: Health Care Issues for Seniors: Current Problems, Prospective Solutions
Panel Presentation: Health Care
Roger Bermingham, MD
Ft. Collins, Colorado
Health care for seniors in America is slowly approaching a crisis point. The focus of the talk will be outlining those issues as well as delineating some possible approaches to the problem.
Some of the major current issues include health care access, lack of training in health care for seniors, fragmentation of care and the tendency to discount health problems as just “normal aging.” Health care access in the past has been primarily through primary care internists and family physicians, with some access in recent years through non-physician providers such as Nurse Practitioners. Recent years have seen a dramatic decline in the number of physicians going into primary care internal medicine. Economic factors related to the cost of doing business versus reimbursement for senior health care have caused all classes of providers to either limit the number of seniors in their practice and to cut the amount of time allotted for office visits. Specialists can often still be accessed by seniors but often have little training in geriatric principles related to their specialty. This results in over prescribing, referral to more specialists and increased fragmentation of care for seniors—often at a higher cost to both the patient and society.
Seniors themselves, as well as many health care providers, will often ascribe complaints of seniors to normal aging—this includes such issues as joint pain, poor balance, bladder problems and memory issues. This results in under-diagnosis of potentially remedial health care problems.
There is no one solution to the current issues in senior health care. Better training for both primary care physicians and specialist are currently being offered more broadly. The current push for the Patient-Centered Medical Home has hopes for providing more complete care, if reimbursement is improved. Alternative programs such as the federally funded Program for All Inclusive Care of the Elderly have some promise for the frail elderly. Other possible models of care include non-office based provision of care and alliances between lay groups and health care providers.
