Whenever we are searching for a new healthcare provider, it is a profoundly personal and sometimes difficult decision. As we age, medical needs often become more complex, with multiple medications, overlapping conditions, memory and mobility challenges, and decisions that directly affect comfort and quality of life. You deserve a clinician who understands not only medicine but the realities of aging: someone who listens, coordinates care and treats you with dignity. No matter the clinician you choose, passion in practice should be evident and make all the difference in our decision and in the care we receive.
Understanding Your Options
Physicians (MD or DO)
Physicians complete medical school, residency training, and may pursue additional fellowship training in specific fields. Their education is extensive, typically lasting 7–10 years after college.
Internal Medicine
Complete a residency in internal medicine focused on adult patients, diagnosing and managing complex medical problems, chronic diseases, and hospital-based care. Often act as primary doctors for adults with multiple conditions or as specialists.
Family Physicians
Train broadly across all age groups from babies and childhood to older adults and across settings (clinic, hospital, outpatient). Their strength lies in continuity, preventive care, and a holistic perspective across life stages.
Geriatricians
Begin with either internal or family medicine training, then complete a fellowship in geriatric medicine. They are considered experts in the nuances of aging, including polypharmacy (the use of multiple medications), frailty, cognitive impairment, functional decline, fall risk, transitions of care, and aligning care with personal goals and quality of life.
Physician Assistants (PAs)
PAs are licensed medical professionals who diagnose, treat, and prescribe medications under the supervision of a physician. Training includes a master’s level PA program and clinical rotations in multiple specialties. Some may have received additional fellowship training in a specialized field such as internal medicine, family medicine, or geriatrics. Experienced in caring for older adults can provide excellent continuity of care, particularly when they work closely with supervising physicians and interdisciplinary teams.
Nurse Practitioners (NPs)
NPs are advanced practice registered nurses (APRNs) who hold a bachelor’s degree in nursing, are licensed as a registered nurse (RN), and are graduates of a master’s or doctoral-level nursing program with additional advanced clinical training. Depending on state law, they may practice independently or in collaboration with a physician. For the older adult patient population, NPs typically have education programs that focus on Adult-Gerontology Primary Care (AGPCNP), Adult-Gerontology Acute Care (AGACNP), Family Practice (FNP), or Psychiatric-Mental Health Nurse Practitioner. Often, it brings a holistic approach, emphasizing education, prevention, and patient advocacy, which are all important aspects of caring for older adults and caregivers. Many NPs lead geriatric-focused practices, especially in home-based primary care and assisted living settings.
Why Geriatric Training and Focus Matter
Older adults have unique healthcare needs. Illness may present differently; for example, pneumonia might cause confusion rather than fever, or heart disease might present as weakness rather than chest pain. Clinicians with geriatric training learn to recognize these patterns and tailor care accordingly.
The curriculum required for completion of a Physician Geriatric fellowship, Adult-Gerontology specialization (for NPs), or Advanced Practice Provider Geriatric fellowship (for NPs or PAs) consists of:
- Comprehensive geriatric assessment (function, cognition, mood, mobility, and medications).
- Safe medication, prescribing, and deprescribing.
- Managing dementia, delirium, and frailty.
- Care planning that aligns with patient goals and life stage.
- Coordination among multiple specialists and caregivers.
Studies have shown that geriatric-focused care improves outcomes, reduces hospitalizations, and enhances the quality of life for older adults.
Which Type of Clinician Is Right for You?
| Your Needs | Best Fit | Why |
| Multiple chronic conditions, cognitive changes, or frailty | Geriatrician, Geriatric NP, or PA with a geriatric focus | Specializes in balancing risks, optimizing medications, and focusing on function and quality of life. |
| Stable chronic conditions or preventive care | Family Physician, Internal Medicine Physician, NP, or PA with experience in older adult care | Skilled in ongoing management, coordination, and preventive strategies. |
Tip: Don’t focus only on credentials. Look for clinicians who actively care for older adults, demonstrate interest in aging-related issues, and collaborate with multidisciplinary teams.
Seeking “Aging Friendly” Care
You may benefit from a geriatrician, geriatric NP, or PA if you or your loved one experiences:
- Repeated hospitalizations or slower recovery from illness.
- Increasing medication lists or frequent side effects.
- Memory changes, dementia, or confusion.
- Falls or mobility problems.
- Difficulty managing multiple specialists.
- Caregiver strain or complex care coordination needs.
When evaluating a new provider, be sure to find the best practice that fits you or your loved ones’ needs. It is vital to look beyond a medical practice’s appearance. Don’t be afraid to ask questions, read reviews online, and ask plenty of questions. You will know when it is the right practice for you.
Signs that a practice supports the needs of older adults:
- Experience: At least 25% of their patients are age 65+.
- Time and patience: Longer time for visits due to complex cases.
- Care coordination: Collaboration with home health, therapists, and pharmacists.
- Medication safety: Routine reviews for interactions or unnecessary drugs.
- Accessibility: Telehealth options, mobility-friendly offices, and caregiver involvement.
Questions to Ask When You Call the Office
The answers and the manner in which the office staff responds can often reveal a clinic’s comfort and competence in caring for older adults.
- Do you accept new Medicare patients?
- What percentage of your patients are above age 65?
- Does the clinician have extra geriatrics training?
- How long are annual wellness visits?
- Can longer appointments be scheduled?
- Who provides coverage for the clinician when they’re away?
- Does your staff consist of a care coordinator, a social worker, or a pharmacist?
- How can we reach the clinician between visits?
- What is the best way to reach the clinician between visits?
- Do you routinely assess fall risk, memory, and medications?
- Do you offer home visits or telehealth?
- How do you coordinate care after hospital stays or specialist visits?
- How many caregivers can attend visits and how can they be included in decision-making?