Frank Molnar is a Canadian Royal College specialist in Geriatric Medicine who serves as the President of the Canadian Geriatrics Society and as the editor of that society’s Continuing Medical Education Journal. He tweets @FrankMolnarCGS
Those outside Specialized Geriatric Services have long had great difficulty understanding what specialists in Geriatrics do. We have contributed to this lack of clarity. As experts in complexity we often have difficulty communicating simply. In well-intentioned efforts to be inclusive and comprehensive we have employed long complex definitions that few outside our field can understand much less recall.
How often have you heard “what do you geriatricians really do?” Are you tired of explaining and re-explaining yourself? Are you looking for a better way to explain and sell our specialty?
We could and should take a page out of the blueprint for industry – present simple user friendly products in the front office (that do not intimidate and scare away visitors) and keep the complexity in the back office (where you and your fellow geriatricians can debate them ad infinitum). Separate sales from tech support.
In 2013 Dr. George Heckman recommended that, rather than developing complex comprehensive definitions, we focus on a few key core competencies and package them in a manner that will better resonate with the general public and with decision makers.1 Such an approach may not capture 100% of what Geriatricians do but would describe the majority of our contributions to health care.
On April 21, 2017 Dr. Mary Tinetti gave the Keynote Address at the Canadian Geriatrics Society Annual meeting in Toronto. During that address she presented the GERIATRIC 5Ms – a simplified communication framework to describe key core competencies in Geriatrics in a manner that those outside the field will be better able to understand and remember. Click here to learn more regarding the GERIATRIC 5Ms (Mind, Mobility, Medications, Multi-complexity, Matters Most)
| GERIATRIC 5Ms© | |
| MIND | Mentation,
Dementia, Delirium, Depression |
| MOBILITY | Impaired gait and balance,
fall injury prevention |
| MEDICATIONS | Polypharmacy,De- prescribing,
Optimal prescribing, Adverse medication effects and medication burden |
| Multi-complexity | Multi-morbidity,
Complex bio-psycho-social situations |
| MATTERS MOST | Each individual’s own meaningful health outcome goals and care preferences. |
Can this new GERIATRIC salute or high five work? Try it out for size. We have and our partners (e.g. general internists, family physicians and even surgeons) have told us “we finally understand what you do … why did it take you so long to explain?”
We sincerely hope Geriatricians everywhere will find the GERIATRIC 5Ms helpful in their advocacy on behalf of our specialty.
Let’s get a dialogue started. Spread the word! Let your friend s know. Email, Tweet or even go old school and talk to colleagues in the halls. Try the GERIATRIC 5Ms out and see how communication and understanding are transformed.
Heckman GA, Molnar FJ, Lee L. Geriatric Medicine Leadership of Health Care Transformation: To Be or Not To Be? Canadian Geriatrics journal 2013; 6(4): 192-195
British Geriatrics Society 
If GM were an art form it would be Abstract but five digits no
Simple greatness!
Hmm Bernard Isaccs reinvented! And continence remains forgotten. However totally agree we need to demonstrate that what we do is not shrouded in mystery but there for others to understand and feel comfortable in emulating. There can never be enough geriatricians to manage all the frail older people out there, so we need to demystify comprehensive geriatric assessment and enable others to care appropriately for the frail in their care. Just as endocrinologists expect others to have a modecum of understanding of the management of diabetes, as there is too much diabetes for them to manage, we must accept that we need to help others develop our skills rather than keep criticising them for not having such skills! Let’s learn to say ‘ how can I help you feel better able to cope with multimorbidity, delirium, and complex discharge planning’.
Thank you rhis is so easy to understand… haha like a one stop shop for us Geriatric folk. Thank you again and Goid Bless you all.
What sets humans apart from most other “animals” are our opposable thumbs! So I would always start with what matters most to the client/patient and the rest is in service to that.
Excellent Information . Thanks TEAM BGS !