Most families don't think about switching to a geriatrician until something's already gone wrong: a medication interaction nobody caught, a fall that seemed to come out of nowhere, a diagnosis that got missed because it looked like normal aging. A geriatrician is trained specifically to catch these things before they become emergencies, and understanding what that training actually offers, and how to find it in Richmond, is worth doing before a crisis forces the question.
A geriatrician is a physician with additional fellowship training specifically in the medical care of older adults, focused on function, independence, and how multiple conditions and medications interact, not just treating one disease at a time.
The distinction matters most once a parent is managing several chronic conditions, multiple medications, or early cognitive changes. In Richmond, VCU Health operates a dedicated geriatric medicine division, and both HCA Virginia and Bon Secours have geriatric-affiliated specialists in their networks.
What Makes Geriatric Medicine Different From a Standard PCP
A geriatrician starts as an internist or family medicine physician, then completes additional fellowship training specifically focused on aging. That extra training shows up in how a visit actually works: appointments tend to run longer, cognitive screening is a routine part of care rather than something raised only when a problem is already obvious, and the underlying question shifts from "what disease are we treating" to "what does this person need to stay independent and functioning well."
That shift matters more than it might sound. A standard PCP is trained to manage individual conditions well. A geriatrician is trained specifically to manage the intersection of several conditions at once, how a heart medication might affect balance, how a sleep aid might affect memory, how one new symptom might actually be three overlapping issues rather than one clear diagnosis.
The Kinds of Problems Geriatricians Are Specifically Trained to Untangle
This training becomes most valuable exactly where a standard visit tends to run out of time or specialization. A few examples worth naming directly:
- Unexplained weight loss can stem from a dozen different causes in an older adult, medication side effects, depression, an undiagnosed illness, or simply reduced appetite tied to aging, and sorting through which one applies takes exactly the kind of whole-person evaluation geriatric training is built around.
- Sleep changes are notoriously hard to evaluate quickly, since some changes are a normal part of aging and others signal something that needs treatment, a distinction that benefits from someone trained specifically in that difference.
- Medication management is arguably the single clearest example. Reviewing a complex medication list for interactions and cumulative effects across multiple prescribers is a core, defining skill of geriatric medicine, not an afterthought.
- Depression in older adults often looks completely different than depression at a younger age, and it's frequently missed by clinicians who aren't specifically trained to recognize how it actually presents later in life.
None of these problems are rare. They're common, and they're exactly the territory where geriatric training earns its value.
Why the Distinction Matters More as Needs Get Complex
For a healthy, active older adult managing one or two conditions, a good general practitioner may genuinely be enough. The calculus changes once someone is managing multiple chronic conditions, several medications from different specialists, or early signs of cognitive change.
At that point, having one physician trained specifically to see the whole picture, rather than several specialists each focused on their own piece of it, tends to prevent the kind of gaps where problems fall through the cracks between appointments.
The Real Shortage You Should Know About
It's worth understanding this isn't just a Richmond issue. According to the American Medical Association, the U.S. currently has roughly 7,300 board-certified geriatricians, less than 1% of all physicians nationally, and the American Geriatrics Society estimates the country will need over 23,000 more by 2030 to keep pace with the aging population.
More than 60% of U.S. counties currently have no geriatric specialist at all. That shortage is part of why it's worth starting the search before a crisis makes timing urgent; availability isn't guaranteed, and waitlists are common.
Finding a Geriatrician in Richmond
VCU Health operates a dedicated Division of Geriatric Medicine with an outpatient clinic at the Ambulatory Care Center downtown, offering geriatric consultation, primary care, and coordinated multidisciplinary care, including a house calls program for homebound patients within 15 miles of VCU Medical Center. Both HCA Virginia (including Henrico Doctors' Hospital) and Bon Secours also have physicians affiliated with geriatric medicine across their networks, even where a dedicated standalone geriatrics division isn't the model. A tool like Healthgrades can help you compare specific geriatricians in the Richmond area by rating, hospital affiliation, and board certification before making a first appointment.
Questions to Ask When Choosing One
A few questions help separate a genuinely geriatric-trained practice from a general practice that simply sees a lot of older patients:
- Is the physician fellowship-trained and board-certified specifically in geriatric medicine?
- How long are typical appointments?
- Does the practice routinely screen for cognitive changes, not just address them when raised?
- How does the practice coordinate with other specialists a patient is already seeing?
- Is the practice currently accepting new patients, and what's the realistic wait time?
You Don't Need to Wait for a Crisis
The best time to find a geriatrician is before an urgent need makes the search feel rushed. Given the real shortage and typical wait times, starting the search when a parent is managing early complexity, not waiting until a fall or a hospitalization forces the question, gives your family far more options.
We're Glad to Talk Through the Bigger Picture
Finding the right medical team is one piece of a much larger picture of what keeps a parent healthy and independent. The Berkeley at Short Pump works alongside residents' physicians and specialists as part of everyday care, not as a separate, disconnected piece. If you're weighing whether assisted living fits into your family's plan alongside strong medical care, get in touch and we're glad to talk through the whole picture with you, not just one part of it.
Frequently Asked Questions
Does Medicare cover visits to a geriatrician?
Yes, geriatrician visits are covered under Medicare Part B the same way visits to any other physician are, subject to standard coinsurance and deductible rules.
At what age should someone start seeing a geriatrician?
There's no fixed age requirement. It depends more on complexity of health needs than age alone, though many families start considering it once a parent is managing multiple chronic conditions or several medications, often sometime in their 70s or 80s.
Can a geriatrician replace my parent's regular primary care doctor?
Yes, in most cases a geriatrician functions as a primary care physician, not an occasional specialist, providing routine and preventive care in addition to managing age-related complexity.
What if there's no geriatrician available nearby?
A geriatric nurse practitioner, or a primary care physician with specific experience treating older adults, can be a reasonable alternative where a geriatrician isn't accessible, and some geriatric practices offer consultative visits even for patients whose ongoing care stays with another provider.
What's the difference between a geriatrician and a geriatric psychiatrist?
A geriatrician handles overall physical health and medical complexity in older adults, while a geriatric psychiatrist specializes specifically in mental health conditions, like depression or dementia-related behavioral symptoms, in that same population. The two often work together for patients with overlapping needs.
SOURCES:
- American Medical Association, "As population ages, need for practicing geriatricians grows more acute": https://www.ama-assn.org/public-health/population-health/population-ages-need-practicing-geriatricians-grows-more-acute
- VCU Health, "Geriatric Services": https://www.vcuhealth.org/services/senior-services-and-continuum-integration/
- Association of Health Care Journalists, "What to know about the geriatric workforce shortage": https://healthjournalism.org/blog/2026/07/what-to-know-about-the-geriatric-workforce-shortage/
- Healthgrades, "Geriatric Medicine Specialists Near Richmond, VA": https://www.healthgrades.com/geriatric-medicine-directory/va-virginia/richmond
