A geriatrician is the doctor who specializes in treating older patients. Geriatricians are physicians trained to manage the complex, overlapping health issues that become more common with age, including memory loss, falls, frailty, chronic pain, and the challenge of taking multiple medications safely. Most people become candidates for geriatric care at age 65 or older, though there is no strict age cutoff. What matters more than a number on a birthday card is whether your health has become complicated enough to benefit from a specialist who sees the whole picture.
What a Geriatrician Actually Does
A geriatrician is a medical doctor who completed training in internal medicine or family medicine and then finished an additional fellowship focused entirely on aging. In the United States, that fellowship lasts at least 12 months and must be accredited by the same body that oversees all graduate medical training. After completing it, the physician sits for a board certification exam through the American Board of Internal Medicine.
What sets geriatricians apart from general internists is their focus on conditions that rarely appear in isolation in older adults. A 78-year-old with high blood pressure, mild memory trouble, depression, and a recent fall is not simply dealing with four separate problems. Each one influences the others, and treating one aggressively can worsen another. Geriatricians are trained to weigh those tradeoffs. Their approach centers on preserving your ability to function independently rather than chasing every lab value back to a textbook normal.
A typical geriatric visit is broader than a standard checkup. It covers physical health, mental health (including mood, anxiety, and cognitive screening), your ability to handle daily tasks like bathing, dressing, cooking, and managing money, and your social situation, including whether you have reliable support at home, safe housing, and access to transportation. This kind of evaluation is called a comprehensive geriatric assessment, and it’s designed to catch problems that a 15-minute office visit would miss entirely.
Conditions Geriatricians Manage
Geriatricians handle what the field calls “geriatric syndromes,” a set of conditions that are common in older adults and often interconnected:
- Frailty and muscle loss: gradual weakness that raises the risk of falls, hospitalization, and loss of independence.
- Falls and mobility problems: identifying the combination of factors (vision, balance, medications, home hazards) that cause someone to fall, and building a prevention plan.
- Cognitive decline and dementia: diagnosing memory problems, distinguishing Alzheimer’s from other causes, and creating a care plan that includes safety planning and caregiver support.
- Polypharmacy: reviewing all medications to spot unnecessary drugs, dangerous interactions, or pills that are themselves causing confusion, dizziness, or fatigue.
- Incontinence: a problem many patients never bring up with their regular doctor but that geriatricians routinely screen for.
- Malnutrition and unintentional weight loss: common in older adults living alone or managing multiple chronic illnesses.
- Delirium: sudden confusion that can be triggered by infection, surgery, or medication changes and is frequently mistaken for dementia.
Medication review deserves special emphasis. Older adults metabolize drugs differently, and the more prescriptions someone takes, the higher the chance that one medication is quietly causing side effects that look like a new disease. Geriatricians and geriatric pharmacists are specifically trained to untangle these situations. If cognitive decline in an older patient can’t be explained by other causes, medication interactions become a primary suspect.
How Geriatric Care Differs From Primary Care
Your primary care doctor can absolutely continue treating you as you age. Many do so skillfully. The difference is one of depth and design. A general internist is trained to manage diseases. A geriatrician is trained to manage the person living with multiple diseases at once, factoring in what matters most to that person: staying at home, remaining mobile, keeping their mind sharp, or avoiding the hospital.
Geriatric patients, as a group, are more likely to have several chronic illnesses at once, to depend on others for daily tasks, and to be dealing with frailty. Each of these realities requires a different kind of clinical thinking. A geriatrician may deliberately deprescribe a blood pressure medication that’s causing dizziness and falls, even if the blood pressure numbers look slightly worse on paper, because the greater threat to that patient’s life is a broken hip.
Geriatricians also coordinate with a broader team. It’s common for a geriatric practice to include nurses, pharmacists, social workers, and physician assistants who all specialize in aging. Social workers on these teams help with issues that go well beyond the exam room: navigating changes in living situation, managing caregiver stress, connecting families with community resources, and planning for long-term care.
Signs It May Be Time to See One
You don’t need a referral to wonder whether a geriatrician would help. Common triggers include noticeable memory changes, a recent fall or fear of falling, difficulty managing medications, unexplained weight loss, increasing trouble with everyday activities, or a general sense that your health has become more complicated than one doctor can easily coordinate. Referrals often come from primary care physicians who recognize early signs of frailty or notice that a patient’s care needs have outgrown a standard visit.
Anyone 65 or older who is concerned about changes in their health, especially when things are becoming complicated or hard to manage, is a reasonable candidate. You don’t need to wait for a crisis.
The Geriatrician Shortage
Finding a geriatrician can be difficult. The United States has roughly 7,000 board-certified geriatricians, a number that has stayed flat for years. That works out to less than one geriatrician for every 10,000 older adults. Projections have estimated the country needs about 28,000 to meet demand. The gap means wait times can be long, and in some areas, geriatricians simply aren’t available.
If you can’t find one nearby, a primary care doctor who has experience with older patients is a solid alternative. Many internists and family physicians incorporate geriatric principles into their practice. Geriatricians themselves recognize that their small numbers mean part of their role is training other specialties to think about aging more carefully.
How to Find a Geriatrician
The American Geriatrics Society maintains a searchable directory through its Health in Aging Foundation website (healthinaging.org), where you can look up geriatrics professionals by state. Every provider listed is a member of the American Geriatrics Society. Your insurance company’s provider directory is another starting point. If you’re on Medicare, geriatric visits are covered, including comprehensive cognitive assessments that result in a written care plan. These assessments can even be done via telehealth.
When calling a geriatric practice, ask whether they perform comprehensive assessments and whether they have an interdisciplinary team. A practice with a pharmacist, social worker, and nurse working alongside the geriatrician will give you the fullest version of what geriatric medicine offers.