[Contributions to the specialty geriatrics. The geriatrician--tolerated or appreciated?].

In this article an outline for the development of geriatrics in the Netherlands is given based on experiences in the United States and Great Britain. From the beginning geriatrics should be brought upon "first class' level in order to avoid the development of a "second class' specialism - unwanted and not respected by other specialists. Therefore in the author's opinion geriatrics should start in the universities as a part of the total education, training and research in medical gerontology which contains not only (somatic) geriatrics, but also physiology, pathology, psychogeriatrics, neurology, general practice and social medicine. To begin with we should start with specialists in internal medicine who make their daily job in geriatrics. New style geriatricians could be educated and gradually take over the posts of the geriatricians of the "first hour' after 5 to 10 years. When an internal ward is changed into a geriatric ward, the modification should not only contain the indication shields, but also include a change of attitude towards elderly patients, more nurses (one on every patient), a psychogeriatric consultant, a social worker, a geronto-psychologist and facilities for disturbed patients, etc. In future geriatricians could be employed on geriatric assessment units in general hospitals, psychogeriatric assessment units in mental hospitals and as consultants in nursing-homes, residential homes and social-psychogeriatric (ambulant) services.