MEDICA.de talked to professor Thomas Klie, president of the German Association of Gerontology and Geriatrics (DGGG) about the necessity of special doctors for old patients and why this discipline is neglected in Germany.
MEDICA.de: Mr. Klie, why do we need geriatric doctors?
Thomas Klie: Not all people need such a doctor with such a specialisation. But we need a geriatric medicine which is concerned with age-related factors of health and disease. Age is characterised by polymorbidity which means that several diseases exist in one person at the same time: a visual defect, high blood pressure, diabetes, osteoporosis. Such problems occuring at the same time often call for a special treatment. The aspects of prevention and rehabilitation are very important. The geriatrician identifies patients at risk and can advise them on a healthier way of life. This saves medical costs and the patient's quality of life increases.
MEDICA.de: Would it not be sufficient to have special centres in which medical specialists from different areas are concerned with the treatment of older people?
Klie: That would not be sufficient, because medical specialists often lack the special knowledge on high age. Many drugs have another effect in 80-year-old people than in 40-year-old ones. However, this is an aspect which already is neglected in research.
MEDICA.de: Do you think that Germany is prepared for the demographic change?
Klie: No. Geriatric medicine is a neglected discipline in Germany. There are only two chairs for geriatric medicine at the Universities of Nuremberg and Bochum. Furthermore, there exist four endowed chairs. When we compare that with Italy, we observe 61 chairs for geriatric medicine there. In Germany, we also lack of a convincing continuing education. We do not have physicians being specialists in geriatrics in Germany, physicians can only get further education in this area and a qualification in geriatrics. This is due to the fact that ther Germans have not yet accepted the demographic change as a political challenge, especially healthcare political one.
MEDICA.de: What are the reasons?
Klie: Individual disciplines like internal medicine or psychiatry are very powerful. Each doctor represents his own discipline. Since geriatricians work interdisciplinary, many medical specialists experience them as being competition since patient groups partly overlap each other. Interdisciplinarity is the central sign of gerontology and geriatrics but this is an area generally neglected in science and research politics as well as health care and social politics in Germany. That is why it is so difficult to get research funding for interdisciplinary projects.
MEDICA.de: Are there any other reasons?
Klie: Yes, since any discussion is influenced by values in society and culture, there are other reasons: High age is not very sexy in Germany. Medicine today still is curative oriented. The chance of cure in 80 year old people is another than in 40 year olds. There we have to change of thinking.
The Interview was conducted by Simone Heimann.