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Comparative Study
. 2008 Oct;56(10):1807-11.
doi: 10.1111/j.1532-5415.2008.01942.x.

A comparison of how generalists and fellowship-trained geriatricians provide "geriatric" care

Elizabeth A Phelan  1 , Scott Genshaft, Barbara Williams, James P LoGerfo, Edward H Wagner
Affiliations
Comparative Study

A comparison of how generalists and fellowship-trained geriatricians provide "geriatric" care

Elizabeth A Phelan et al. J Am Geriatr Soc. 2008 Oct.

Abstract

Objectives: To determine whether outpatient care provided to older patients by fellowship-trained geriatricians is distinguishable from that provided by generalists.

Design: Observational study.

Setting: Three primary care clinics of an academic medical center.

Participants: Random sample of 140 adults aged 65 and older receiving primary care at one of the clinics.

Measurements: A medical chart review involving records of 69 patients receiving primary care from a fellowship-trained geriatrician and 71 patients receiving primary care from a generalist (general internal medicine or family practice) was conducted; information pertaining to two practice behaviors relevant to the care of older adults--avoidance of inappropriate prescribing and proactive assessments for geriatric syndromes--was abstracted.

Results: Geriatricians scored 17.6 out of a possible 24 points, on average; generalists scored 14.2 (P<.001). Geriatricians scored higher than generalists on prescribing and geriatric syndrome assessments. In a linear regression model adjusting for patient age and number of comorbidities and clustering according to provider, provider specialty was strongly associated with overall score (beta coefficient for specialty=6.75, P<.001; 95% confidence interval=4.57-8.94).

Conclusion: The practice style of fellowship-trained geriatricians caring for older adults appears to differ from that of generalists with regard to prescribing behavior and assessment for geriatric syndromes.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

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