Search for Geriatrician Identity: Mary Tinetti, Helen Fernandez, Jerry Gurwitz, Ken Covinsky

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GeriPal - A Geriatrics and Palliative Medicine Podcast 50 min 3 speakers 6 chapters transcribed 10 hours ago

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What is the purpose of this episode and who are the featured guests?

Eric Widera 0:00

This podcast is not CME eligible. If people do want to learn more about CME eligible podcast, Alex, what do they do?

Alex Smith 0:07

They can go to cherrypal.org backslash CME.

Eric Widera 0:13

And on to the show. Welcome to the Jerry Powell podcast. This is Eric Widera. This is Alex Smith. Alex, we are going to be talking about geriatricians. What's our identity? Before we jump into that topic, who do we have on the podcast to join us?

Alex Smith 0:27

We have an all-star lineup today, Eric. We are delighted to welcome back, all returning to the Jerry Powell podcast, Mary Tenetti, who's a geriatrician researcher at Yale. Mary, welcome back to the Jerry Powell podcast.

Mary Tinetti 0:43

Great to be here.

Alex Smith 0:45

And Jerry Gerwitz, who's a geriatrician and researcher at UMass Chan Medical School. Jerry, welcome back to Jerry Pal.

Jerry Gurwitz 0:53

Hi, everybody.

Alex Smith 0:54

Helen Fernandez, who's a geriatrician, palliative care doc, and educator at Mount Sinai in New York City. Helen, welcome back to Jerry Pal.

Helen Fernandez 1:04

Thank you. Really happy to be here.

Alex Smith 1:06

And Ken Kavinsky, geriatrician researcher at UCSF. Ken, welcome back. Great to be back. Thank you.

Eric Widera 1:12

So, you know, the way this topic came up is that we got a lot of JAGS articles recently about defining geriatrics, the geriatrics identity, and a couple other cool ones that we're going to be talking about in this podcast. But before we dive in this topic, we always start off with a song request. Mary, do you have the song request?

Mary Tinetti 1:32

I do. I was hoping you would do the Streets of Minneapolis, Bruce Springsteen.

Eric Widera 1:37

Why did you choose this song, Mary?

Mary Tinetti 1:39

So I did my training in Minneapolis, and I fell in love with that city. And I was so proud and not at all surprised at the heroics and what they did this winter that no one else has done. Minnesota is kind of the quiet place where people just do the right thing. That kind of reminds me of geriatricians. Minneapolis has finally got its place in the sun, and I hope you do too.

Alex Smith 2:07

That's great. Wonderful. Here's a little bit protest song.

Unknown 2:19

Down to Glade Avenue A city of flame, full of fire and ice Neath an occupier's boots King Trump's private army from the DHS Guns built it to their codes Come to Minneapolis to enforce the law Or so their story goes Oh, Minneapolis, I hear your voice singing through the bloody mist. We'll take our stand for this land and the stranger. And here in our homes they killed and roamed in the winter of 26. We'll remember the names of those who died on the streets of Minneapolis.

Eric Widera 3:29

Wonderful song. Thank you, Mary, for that request. Okay, let's talk about... So recently, there are multiple JAGS articles, Journeymark and Geriatric Society. Congratulations, Alex, by the way, for your co-chief editor of JAGS. What's the actual title?

Alex Smith 3:46

Co-editor... I can't say it. Co-editor-in-chief with Deb Saliba. Yeah, really excited about this new position.

Eric Widera 3:54

Congratulations, Alex. Really

Alex Smith 3:55

grateful to Joe Auslander for all the work he's done and the lessons I've learned from him.

Eric Widera 4:00

So, Jerry, you wrote an article in search of geriatrician identity. Mary, you also wrote an article recently published this year on mainstream or extension can defining who we are save geriatrics 10 years later. I'm going to start off with you, Jerry. First of all, like, why do you want to write an article about geriatric identity?

Jerry Gurwitz 4:22

Yeah, thanks, Eric. A number of years ago, I read this piece in JAGS, and it was titled The Unknown Profession, a Geriatrician. Jean Campbell wrote it with a number of her colleagues. And what I couldn't get out of my head and still can't is this video that was attached to that article. And I really encourage anybody who's listening to this podcast to access that video. And what the authors did was to interview people on the street and ask them, what is a geriatrician? And the answers were related to Ben and Jerry's ice cream, gerrymandering, being on a jury, a whole bunch of other things, nothing to do with geriatrics. And I mean, I found it funny and hilarious, but I also found it a little disconcerting and sad and

Jerry Gurwitz 5:22

So I encourage anybody who's listening to watch that video. Many others, especially Mary, have written about geriatrician identity over the years, and I felt like, well, it was time to give it a shot.

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Chapters

6 chapters

1 What is the purpose of this episode and who are the featured guests? 0:00–7:43 2 Why did Mary choose the “Streets of Minneapolis” song and what does it symbolize? 7:43–22:18 3 What does the humorous Baltimore street‑interview video reveal about public perception of geriatricians? 22:18–28:37 4 What are the four (or five) geriatrician identity types described by Jerry and Ken? 28:37–39:40 5 How does Ken’s “identityist” perspective reshape the conversation about geriatrician identity? 39:40–49:04 6 What is the Med‑Geri combined residency‑fellowship program and how does it aim to grow the field? 49:04–50:27

Speakers

3 identified

Eric Widera 8 min Alex Smith 4 min Illia Polosukhin

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Topics in this episode

FDA 1 Alex Smith 2 Eric Widera 1 Jags 2 Ken Covinsky 1 Mary Tinetti 1 Helen Fernandez 1 Jerry Gurwitz 1 Society of General Internal Medicine 2

Source

Recorded21 May 2026

Publisherrss.libsyn.com ↗

Transcriptspeaker-named · 100+ languages

Handlerec:20524459

Show notes

Our focus today is on the search for the geriatrician identity, a continuation of the conversation we started with Jerry Gurtwitz on the Future of Geriatrics. Today's conversation is prompted by multiple articles in JAGS: (1) an article by Jerry Gurwitz with a title the same as this podcast; (2) an article by Helen Fernandez on "Med-Geri", a new combined 4 year internal medicine residency and geriatrics fellowship track; and (3) an article by Mary Tinetti titled, "Mainstream or Extinction: Can Defining Who We Are Save Geriatrics?" Of note, Mary's article is a follow up to her 2017 article in JAGS in which she wrote: Those outside the field have difficulty understanding what geriatrics is and what geriatricians do. We contribute to this lack of clarity. We are experts in complexity but are often bad at communicating simply. Our well-intentioned efforts to be inclusive and comprehensive lead to the creation of long, complex descriptions of what we do that further compromises understanding while eroding interest in, and support of, our field. Today we tackle this problem, discussing: A "funny if it wasn't so painful" video and JAGS article in which geriatricians from Johns Hopkins roamed the streets of Baltimore asking lay people "What is a geriatrician?" The responses (something to do with Ben and Jerry's ice cream? Jury-atrician?) will make you laugh and cry at the same time. 4 different types of geriatricians as described by Jerry in his JAGS paper: the complexivist, the healthful longevitist, the syndromist, and the contextualist. As with the 4Ms, Ken couldn't help but add a 5th, the "identityist", arguing that maybe Geriatricians worry too much in public about their identity, and should instead focus in public on what unites them: shared sense of purpose and mission to focus on whole person care and what matters most to older adults. Ken gave a rousing talk on being a Geriatrician at the Society of General Internal Medicine that received a lengthy standing-ovation (and a Cubs Jersey with his name on it). Innovative new programs such as Med-Geri and GeriPal fellowship as ways to bring more people into the profession. How to balance our effort between recruiting specialist geriatricians to the profession and teaching all clinicians geriatrics principles and skills. A paper in JAGS by Richard G. Stefanacci and Ankur Patel in JAGS making the argument that a geriatrician "yields per-patient annual net cost savings of approximately $3495 (specialist consultation avoidance +$1500; ED reduction +$45; hospitalization reduction +$1950)..." and "The reason fee-for-service fails geriatricians is not that their skills are wrong for primary care—it is that the payment model is wrong for their skills. Payvider programs operating under capitation invert every structural disadvantage of fee-for-service. Under capitation, there are no RVUs. There is no penalty for spending 40 min with a complex patient. There is no revenue loss when the patient is dual-eligible rather than commercially insured—the capitated payment is the same regardless of original coverage source. And every unnecessary specialist referral, every avoidable hospitalization, every ED visit that could have been managed in-house represents a cost to the organization rather than a revenue stream." Stay until the end when Mary has one of the best answers yet (in over 400 podcasts!) to Eric's "if you had a magic wand" question. Enjoy! -Alex Smith

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