IS GERIATRICS A PRIMARY-CARE OR SUBSPECIALTY DISCIPLINE

Objective: To determine how much of the clinical care provided to olde r persons by geriatricians is primary versus consultative. Design: Nat ional Survey. Participants: Candidates for the 1988 certifying examina tion in geriatrics, physicians who expressed interest in the examinati on but did not register for the examination, and physicians who expres sed no interest in the examination (comparison group physicians). Resu lts: Based on a 72% response rate, 78% of the care rendered by certifi ed internal medicine geriatricians and 90% of the care rendered by cer tified family practice geriatricians to older persons was primary care . Internal medicine geriatricians spent a greater percentage of their care of older persons providing primary care compared with internists with no interest in geriatrics. Although internist geriatricians who w ere formally trained or had additional subspecialty certification prov ided less of their care as primary care compared with geriatricians wh o had no formal training, the majority of care (approximately 70%) pro vided by each of these two subgroups was primary care. Conclusions: Th e vast majority of care provided to older persons by geriatricians is primary care, and these physicians should be considered as generalists for health policy and educational purposes.