LocumLife - July 2008 - (Page 16)

Caring for the older generation they present with all kinds of conditions besides just those urologic in nature. But that keeps things interesting,” he notes.“For example, they could be coping with heart disease, eye problems, and bone conditions in addition to prostate and bladder issues. Some veterans may display the residual effects of post-traumatic stress disorder, and there are —Abi Rayner, MD, MPH quite a few with depression, schizophrenia, or dementia. “These multiple conditions can affect the treatment I prescribe,” he adds. “I have to study all of their issues in order to effectively treat them.” Also, patients’ ages must be considered when formulating care plans. While physicians might pursue an aggressive approach with younger individuals, there are other factors to weigh when determining the appropriate steps for seniors. “The challenge is that the cure rate among the elderly is not very high because they are experiencing multiple morbidities. Even with a 65-year-old man with cancer of the prostate, you typically can offer him all the treatment options available. Whereas for an 80-year-old man with cancer, there is only a minimal amount you can do. Most of the time,” states Dr. Rifai, “we stick to noninvasive options, such as hormonal treatment and certain radiation programs.” Caring for seniors may not always allow physicians to showcase their cutting-edge expertise, but these cases often provide a different sense of personal accomplishment. Dr. Rifai explains, “Elderly patients routinely express a great degree of gratification. I have found their level of appreciation very high, and that provides me with a great deal of professional and personal satisfaction.” FITTING IN As a family medicine specialist, Abi Rayner, MD, MPH, has spent the greater part of her 27-year career caring for geriatric patients. In fact, from 1991 to 2005, she cared solely for older individuals. “The reality of primary care is that the majority of your time is spent with the elderly. About 50% of my practice was devoted to evaluating and managing dementia, with a particular interest in behavioral disorders associated with this condition,” she comments. Dr. Rayner currently holds two state licenses and is in the process of securing a third. “The rewards are great when you can optimize someone’s quality of life by recognizing that small improvements can lead to significant health benefits.” By 2006, Dr. Rayner had become frustrated with the continual reduction of Medicare reimbursements and the resulting effect on her practice. Plus, given the fact that her children were grown and living out their own lives, she decided it was time to pack her bags and head out on locum tenens adventures. “It just seemed like a good opportunity to try my hand at practicing international health.” Through a non-profit organization, Dr. Rayner arranged multiple opportunities in New Zealand over a 2-year span.“I spent as little as 1 week in one placement, and as long as a year at another,” she comments. “I did, however, try to limit my contracts to 4 weeks.” Now back in the States, Dr. Rayner has registered with VISTA Staffing Solutions, headquartered in Salt Lake City, Utah. She is currently fulfilling a 3-month contract in the Northeast before leaving to watch the Olympics in Beijing. From there, she plans to visit her daughter in Europe before heading back to New Zealand. Regardless of where a contract may take place, a universal aspect of a mobile career is fitting in at each new facility. When caring for seniors with multiple needs, there is the added element of conferring with other providers. Says Dr. Rayner, “It is a challenge because you do not necessarily know what resources are available or how to network with other providers in the community, at least at the onset of a contract.” She continues,“Also, the patients are new to you, so you have to pay extra attention to the subtle changes in their function and disease progression. Often, they move more slowly, are taking more medications, and require more assistance from families, all of which you have to incorporate into your practice.” www.LocumLife.com “Open and honest communication helps with the coordination of care.” Health concerns Geriatric patients face a multitude of health conditions. Obesity: More than 40% of people 60 and older are at increased risk for developing diabetes, cardiovascular disease, and certain cancers. Arthritis: The leading cause of disability; it affects nearly half the elderly population. Osteoporosis: This disease impacts approximately 44 million adults age 50 and older, most of them women. Depression: Two million elderly people suffer a depressive illness and 5 million more may present depressive symptoms that fall short of meeting full diagnostic criteria. Source: Skarnulis, L. (2006, December 9). 7 Health challenges of aging. WebMD. Healthy Aging Health Center. Retrieved June 19, 2008, from http://www.webmd.com/healthy-aging/features/aging-health-challenges 16 LocumLife JULY 2008 http://www.webmd.com/healthy-aging/features/aging-health-challenges http://www.LocumLife.com

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LocumLife - July 2008 Editorial From Nalto Stat! Survey Says Last-Minute Luxury Dynamics Caring For the Older Generation Enjoying the Rewards of a Locum Tenens Lifestyle Advertisers' Index Opportunities Direct Going Mobile Contest Rules Anyone's Guess La Vita Locum

LocumLife - July 2008

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