A young doctor’s drive to care for older adults

Just about everyone knows at least one kid who announces early on that they want to be a doctor when they grow up. Dr. Kim Ann Dang, a board-certified family medicine doctor affiliated with SharpCare Medical Group, was one such kid. But it wasn’t until she was an intern in her first year of residency that she discovered she wanted to be a doctor who specializes in the care of older adults.

Raised in the Bay Area by her parents who emigrated from Vietnam, Dr. Dang attended medical school at Howard University. She interned in New York City, and then wrapped up her residency and completed a fellowship in Georgia before heading to San Diego to practice medicine. It was during that year in New York where her interest in geriatric medicine and palliative care was sparked.

“The need for geriatric medicine and palliative care was coming to the forefront of medicine,” Dr. Dang says. “And the hospital in New York had a well-developed palliative medicine department. As an intern, one of my first patients was making the transition from aggressive care to care and comfort, or hospice. It really left an impression on me.”

Dr. Dang says that she would visit with the patient daily to talk not only about her care, but also about her life and her resolve to embrace the end of her journey. The patient openly shared with Dr. Dang her thoughts about the treatments and procedures she had gone through in the name of her health, and how some of those very treatments started taking her away from the things that brought her joy.

“It really redefined what ‘do no harm’ meant for me,” Dr. Dang says. “With all the knowledge and innovation medicine has brought us, it still needs to be put into the perspective of the patient — personalizing it to their values and motivations.”

A day in the life of Dr. Dang
With a focus on patient-oriented care — preserving the quality and dignity of patients’ lives — as her focus, Dr. Dang’s workday is a little different than that of other physicians. She works in a variety of settings throughout the week, but her day is usually guided by a family meeting.

“This is one field where I have the luxury of time with my patients and their families,” she says. “I meet with them to gauge their understanding, values and challenges. Armed with that, I will reach out to specialists, social workers, the nursing team and chaplains to coordinate a plan to help them get where they need — and want — to be.”

And according to Dr. Dang, these meetings aren’t always as sober as one may suspect. Many patients find it both hopeful and empowering to have someone take the time to ask what is important to them.

In fact, Dr. Dang believes these types of discussions should be held far earlier than when a patient is reaching the end of their life. Palliative care, she says, is often mistakenly equated with end-of-life care. However, patient-oriented interventions and palliative care can offer benefits at all stages of a disease.

“Palliative care focuses on improving quality of life through symptom management and support for the patient and the patient’s family, which are tenets that can and should be applied at any point along the trajectory of an illness,” she says. “I always tell my patients, ‘Let’s have this conversation before there is an emergency, while you still have a voice in what takes place.’”

Creating a path for future care providers
Dr. Dang is pleased to report that more new doctors are seeing the importance of specializing in geriatric, hospice and palliative medicine, as she did. However, she notes that the demand for such care — and the importance of those conversations about what patients value most — is increasing at an exponential pace as the massive baby-boom generation ages.

According to the U.S. Census Bureau, all baby boomers will be age 65 or older by 2030. This marks a shift in the population that some are calling the “gray tsunami.” In fact, older adults are projected to outnumber children under age 18 for the first time in U.S. history by 2034.

“They peaked at 78.8 million in 1999, remained the largest living adult generation until 2019, and they’re currently between 57 to 75 years old,” Dr. Dang says. “They represent one of the greatest generations — it’s our responsibility to provide them with the highest quality of life,” she says.