Purpose: The purpose of the study was to understand better the clinical collaboration process among primary care physicians (PCPs), case managers (CMs), and geriatricians in integrated models of care. Methods: We conducted a qualitative study with semistructured interviews. A purposive sample of 35 PCPs, 7 CMs, and 4 geriatricians was selected in…

In national survey of fellows trained in geriatric medicine and psychiatry, vast majority of former fellows expressed satisfaction with current work. Satisfaction with career choice in geriatrics was significantly greater among physicians who had practices with large numbers of patients over 75, accepted Medicare assignment, spent time as…

Purpose: This study describes the goals, development, and outcomes of an innovative, interdisciplinary, Master of Gerontology department, one of two programs in Israel developed to answer Israel's needs for highly educated researchers and practitioners. Design: Key program components reflecting the program's innovative nature are described: (a)…

To successfully practice geriatrics, one must keep up-to-date with rapidly evolving knowledge, recognize heterogeneity among older people, seek answers through longitudinal studies, and accept no symptoms nor loss of function as being simply old age. Functional loss must be the focus and thus rehabilitation is essential to good geriatric care.…

Surveyed 24 key informants concerning new geriatric program. Found inservice education program and hospital-based community resource directory were received positively and implemented quickly. Community physicians hesitated to make referrals to geriatric assessment team, citing fear that team would steal patients and threats to physicians'…

Examined knowledge of geriatric health policies of 154 physicians training in medicine, surgery, and psychiatry. Found a widespread lack of knowledge that could interfere with physicians' ability to use the health care system appropriately for patients' benefit and to function effectively as a gatekeeper to health care utilization. (Author/ABL)

Purpose: The purpose of this study was to examine racial/ethnic differences in the relationship between functional disability and the use of health care services in a nationally representative sample of older adults by using the Andersen behavioral model of health services utilization. Design and Methods: The study used 12 years of longitudinal…

Interviewed 140 elderly medical patients and found that the measured 22 percent prevalence of mental impairment was not reflected in the patients' utilization of mental health services or in their presenting complaints to their physicians. Subsequent interviews with their physicians revealed inadequate recognition, diagnosis, and treatment of…

Purpose: This study aims to develop ah in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis…

Notes that practice of geriatrics frequently involves interdisciplinary team and that behavior of team members exists on functional continuum, from adaptive to maladaptive. Sees danger of team members with maladaptive behavior, and persons colluding with this behavior, negatively influencing care. Categorizes common maladaptive behavior patterns…

The use of interventions claiming to prevent, retard, or reverse aging is proliferating. Some of these interventions can seriously harm older persons and aging baby boomers who consume them. Others that are merely ineffective may divert patients from participating in beneficial regimens and also cause them economic harm. "Free market…

Evaluated medical residents and discovered that although they considered detection and treatment of comorbid depression to be important, they knew few of the diagnostic criteria and etiological factors, rarely screened patients for depression and viewed current treatments as only marginally efficacious. Discusses implications for graduate…

Examined models for predicting treatment decisions of physicians, nurses, and social workers within acute and long-term care settings. Elicited treatment choices to vignettes regarding decisions to allocate scarce medical resource and to withhold treatment from debilitated patient. Primarily medical factors predicted decision to allocate…

Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

Pharmacists (N=233) responded to the question "What is the most difficult aspect of geriatric pharmacy practice?" Most commonly cited problems were (1) inadequate professional skills or knowledge in geriatrics; (2) patient compliance; (3) physician functioning (including overprescribing of medications); (4) communication with the elderly; (5) lack…