Dr. Tsewang Gyurmey, chief medical officer at PACE Organization of Rhode Island, has been seeing patients at PACE centers in Providence, Westerly and Woonsocket since he joined the group in 2012.
With specialties in geriatric and family practice medicine, he also makes visits to patients’ homes, nursing homes, assisted living facilities and skilled nursing facilities.
Gyurmey, who was recently named clinical assistant professor of medicine at the Warren Alpert Medical School of Brown University, discusses the new position and his perspective on the availability of health care for seniors in Rhode Island.
PBN: How will your new role at the Warren Alpert Medical School help benefit PACE participants?
GYURMEY: One hundred and sixty-one students from 12 institutions interned with PACE-RI in 2018, and nurturing these academic affiliations is very important to us. Today’s students are tomorrow’s leaders, so we need their active and ongoing involvement in our work with participants to redefine what successful aging looks like. Their perspectives continually challenge us to be at our best and offer new insight into the chronic medical conditions and behavioral health challenges our participants have. We hope to see more medical students who can be educated to the PACE model of care.
PBN: What do you plan to focus on with this new connection to the academic medical community?
GYURMEY: There are PACE organizations in 31 states, serving 50,000 older adults with complex medical conditions, that produce remarkable results but are still somewhat unknown in the medical community and amongst the general public. Our interdisciplinary teams are made up of 11 professionals who meet daily to consider the whole person, address social determinants of health, and tailor care plans to the specific needs of each participant to keep them out of nursing facilities and living safely at home for four years, on average. I want to focus on bringing this information and innovative approach to as many people as possible and change how our community thinks about aging and care delivery.
PBN: What do you hope to gain from serving in the Brown University Community Mentorship program?
GYURMEY: I grew up in India with extended family and elders living in our home and volunteered to take care of geriatric nuns and monks at a nearby monastery. Those experiences and informal advisers were formative for me, and I love to learn from the diverse experiences of others. Through this opportunity to mentor medical students, I hope to teach clinical skills and knowledge, but also serve as a trusted adviser. I am eager to learn from the students, too, with their fresh perspectives!
PBN: Have you noticed any challenges in attracting young doctors into geriatric medicine?
GYURMEY: Yes … previously, some saw geriatrics as less glamourous than other subspecialties and most geriatric rotations were in the form of electives. This led to less geriatric exposure during medical school training. Now, however, more schools are incorporating mandatory geriatric-based curricula during training and, if you look at the residency to fellowship matches for the past four years, there has been a steady increase in the number of geriatric fellowship positions filled.
The Rhode Island geriatric population is expected to increase by 75% between 2010 and 2040, so the demand for these new providers is significant. Along with programs like the community mentorship and medical student and resident rotations through PACE, we hope to make an impact and be an employer of choice.
PBN: Is there a need for improvement in Rhode Island’s health care resources and services available for seniors?
GYURMEY: The PACE model is built on the belief that we need to address the totality of the person in order to help them achieve good health and wellness. We fill the traditional senior-related social determinant service gaps like transportation, food insecurity and isolation, as well as medical gaps like behavioral health, addiction and pain management, and dementia care.
In addition to managing substance use disorders, we also offer complementary medicine in the form of acupuncture, reiki, tai-chi gong, restorative exercises and therapeutic massage treatments to combat pain. Because we are both the provider of care and insurer, we can think and act differently, and we want to be an example of how to make the system better and more responsive for all older adults.
Elizabeth Graham is a PBN staff writer. She can be reached at Graham@PBN.com.