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New UMD program benefits geriatric care

Elizabeth Nesset knows that when she graduates from medical school she wants to specialize in geriatrics, the treatment of older people. But already, thanks to a new and one-of-a-kind program at UMD's med school, Nesset is getting personal experi...

Elizabeth Nesset knows that when she graduates from medical school she wants to specialize in geriatrics, the treatment of older people. But already, thanks to a new and one-of-a-kind program at UMD's med school, Nesset is getting personal experience building a doctor-patient relationship with an elderly woman.
The strategy of the new program is to pair medical students with elderly patients so that the two have repeated visits over two years. "It's easier to take care of somebody that you know," said Dr. Glen Nordehn, D.O., who developed the new approach. "When people are in medical school, they follow a doctor around and they meet a bunch of patients. Every patient they meet is new. So we decided that it would be good to have them see somebody over and over and over again, and maybe come to the realization that it's easier to do that, and it provides for better patient care."
"I came here knowing I wanted to go into geriatric medicine," Nesset said. "I want to take care of an older population. When I heard about the geriatric program, I got very excited. I absolutely had to be in the program."
Nesset meets her patient once a month at the patient's Cloquet home. They talk about a variety of things, while Nesset learns firsthand how the woman lives with a disability. "My patient right now is someone who isn't capable of walking around her house," Nesset said. "She can do four or five steps at a time, but for the most part she's in a wheelchair. For me, it gives me perspective on how her life has changed by her decreased mobility -- how her furniture has to be arranged and how she functions on her own. Your patients can tell you stuff in the clinic, but this is actually what's going on in her home."
The innovative program is drawing some attention on the national level. Nordehn was in California last week presenting the course outline to a gathering of medical educators from around the country. Besides improving student understanding of geriatric lifestyles, the program could save the whole industry money in the long run.
"If a person goes to a big clinic for a geriatric evaluation, they get to see a neurologist, some sort of general practicing type person -- a family practitioner or an internal medicine person, a nutritionist, a social worker, whatever. They give them some tests, and they check this and check that," Nordehn said. "Our students, by the end of two years, should be able to do all that in their office rather than sending them to 14 different doctors at some big referral clinic."
Nesset is also learning that getting to know a patient does more than help doctors understand where that person is coming from, but also helps the patient feel more relaxed around their doctor. "I talk to her on a regular basis, and it's amazing the difference in terms of our level of confidence in what's she's willing to share with me from our first meeting as opposed to now," Nesset said, "which is exactly how a physician-patient relationship works. Once you're comfortable and have an established relationship with somebody, you're obviously going to be more open and willing to discuss things."
The geriatric longitudinal experience is in its second year. This year UMD started a pilot OB longitudinal experience modeled after the geriatric program. In this case, students follow the care of a pregnant woman for nine months.
Jennifer Simonson is a news and health reporter for the Budgeteer News. Contact her at 723-1207 or at jsimonson@duluth.com .

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