Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    


More than Just a Number


 
Harvey J. Murff, MD, MPH

Dr. Harvey Murff Urges Providers to Rethink Senior Care

Growing older shouldn't mean fewer options in care. That's what Harvey J. Murff, MD, MPH, is trying to instill in medical students and staff, alike. The interim chief of geriatrics at Vanderbilt University Medical Center arrived at VUMC in 2002 and has been instrumental in research and training efforts geared toward creating better outcomes for older Americans.


Coming Home

A Memphis native, Murff majored in history at the University of Mississippi but grew interested in medicine at the encouragement of his pre-med roommate.

He went on to attend the University of Tennessee Health Science Center in Memphis, followed by an internal medicine residency and a year of chief residency at The Mount Sinai Hospital in New York City. Following a fellowship at Brigham Young Women's Hospital in Boston, he received his Master of Public Health from the Harvard School of Public Health before returning home to Tennessee.


A Growing Need

"I was hired for my interest in research, and Vanderbilt was really pushing their focus on patient safety and quality of care," said Murff. "They want to train people who are leading healthcare into the future and are actively working to develop and educate a workforce in geriatrics."

Faculty in VUMC's Division of Geriatric Medicine recently obtained funding to focus on training non-geriatric physicians and to provide focused geriatric training to a younger generation of medical students. "Geriatrics is such a huge demand, and we're doing what we can to educate and meet that demand," Murff said.

Despite the growing need for geriatric-trained providers - courtesy of an aging baby boomer population - Murff said it's a tough specialty to fill due to misconceptions and an often medically complex population. More diagnoses mean more cognitive work and clinic time - a challenge to providers already pushed to be more efficient and see more patients. And unlike most younger patients, who easily dress and cook for themselves, older patients often require more one-on-one time to ensure basic needs are being met.

"We want to see more influx of younger medical students interested in geriatrics and who decide to pursue that as a career," Murff said. "There have been more and more combined programs after residency and fellowship, and a growing aging population means there are healthy older folks not getting therapy they need because of preconceived notions."

However, Murff said working with older adults has distinct advantages, including an interest in their own health not always found among younger adults. "They have wisdom because they've seen more and are familiar with their health at a deeper level, so you get a partnership that's pretty rich," said Murff, who also works with the Nashville VA Medical Center. "They're usually well aware of things going on and interested in working with you to make sure they have the best quality of life."


Geriatric Research & Care

Offering older patients a better quality of life means asking the right questions, and that's just what Murff and his team are doing behind the scenes. Current research efforts include investigating the use of fish oil to combat a number of health problems, from heart disease and colon cancer to nicotine addiction. That's because smokers are shown to have decreased levels of omega 3, which can drive up anxiety, depression and addictive tendencies.

Murff also oversees clinical activity of VUMC's 24-bed inpatient Acute Care of the Elderly (ACE) unit. "When you're dealing with issues of dementia and cognizant rapid decline, it's helpful to have a very specific geographically localized unit with nurses and staff trained in preventing common hospital-based geriatric problems," Murff said, noting prevalence of pressure ulcers and delirium in older patients. "ACE units are focused on achieving the highest level of functional status," he continued, adding Vanderbilt's internal medicine residents rotate through the ACE Unit and receive geriatric-specific training in VUMC's outpatient clinics.

Researchers also are collaborating with colleagues in other departments to address long-standing age limitations in clinical trials and high-risk procedures, such as transplants. "Age doesn't necessarily account for functional status and frailty," said Murff, who's urging investigators to consider how pre-transplant geriatric assessments might improve the selection process and outcomes for seniors.

"Age alone shouldn't be a cutoff. There are older individuals who are living very active lives and have many good years ahead of them. A doctor might base a decision solely on a number that might seem high, but we need better assessments of frailty," he said. "Age can be a complicated variable, and there are objective and validated measures we can take to identify factors that would better feed into where patients are."


Deprescribing

The division also is leading a study investigating the need to deprescribe medications for seniors. "We see older patients in the hospital taking medication upon medication, and doctors are often hesitant to stop them although we don't know where the meds came from or if they're doing any good," Murff said. "Let's send them out with less meds rather than more. Gigantic medication lists are a very common problem; and as doctors, we don't do as good a job as we should to see what patients do or don't need anymore. There's a great opportunity in the hospital to get pharmacists and their entire team involved, and we believe this research could be very promising," Murff concluded.

WEB:

Vanderbilt Geriatric Medicine

 
Share:

Related Articles:


Recent Articles

Amedisys Expanding Commitment to End-of-Life Care for Veterans

Third Largest Hospice Provider Cared for 5,540 Dying Veterans Last Year

Read More

AMA Applauds Relief from Documentation Burden in New Medicare Rule

Many physicians will have reduced documentation beginning in 2021

Read More

Oncology Innovation in Nashville

From personalized medicine to innovation in GI care, Middle Tennessee oncology leaders share promising news.

Read More

Critical Insights into Nashville Health

For the first time in nearly two decades, Nashville has a countywide assessment providing insights into the health and well-being of the community.

Read More

Physician Spotlight: Leading with Compassion

Hospice care is so much more than simply pain management. Compassus CMO Dr. Kurt Merkelz focuses on helping patients live fully until the end.

Read More

The Oncology Care Model Value Proposition

The American Journal of Managed Care® hosts meetings across the country to help oncology practices understand and navigate the value-based care landscape at the intersection of quality and efficiency.

Read More

Tennessee Falling Short on Cancer-Fighting Public Policies

A 2019 ACS CAN report shows the state is falling short on public policies to fight cancer.

Read More

ONcology Rounds

Middle Tennessee's robust oncology programs are tackling cancer on numerous fronts.

Read More

Focus on Four Key Tax Issues

Now in the second year after the federal Tax Cuts and Jobs Act of 2017 passed, there are a number of considerations healthcare businesses should keep on their radar as they prepare to file.

Read More

Money Management: Smart Strategies at Every Stage

Different stages of life come with different financial necessities from paying off loans to buying a home to preparing for retirement. First Horizon's Matthew Harrison shares smart strategies for every stage.

Read More

Email Print
 
 

 

 


Tags:
Acute Care of the Elderly, Deprescribing, Geriatrics, Harvey Murff, Senior Health, Vanderbilt University Medical Center, VUMC Division of Geriatric Medicine
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: