Green House Blog

Medical & Policy Perspectives on Eldercare with Michael Wasserman, MD

Meghna Datta
Meghna Datta, GHP Summer Intern 2021

Hello! My name is Meghna Datta and I’m an undergraduate intern with The Green House Project (GHP) this summer. I’m a student at Duke, originally from the Midwest, and working here has been a dream of mine for such a long time that being here feels surreal. 

I will be blogging about podcast episodes, webinars, and other GHP content for the duration of the summer and am excited to do a deep dive on developments in the world of eldercare. 

I’ve been following GHP since I read Being Mortal by Atul Gawande, MD, in high school. That book—combined with a rather serendipitous series of events in college—pointed me down the pre-medical path. Specifically, I’m drawn to eldercare and mitigating the impacts of neurodegenerative diseases. So, I am doubly excited to be sharing some reflections on the latest Elevate Eldercare podcast episode.

On His “Why” 

In this episode, Susan Ryan sat down with Mike Wasserman, MD, a geriatrician and tour de force in the world of eldercare and geriatric medicine. When answering the question of why he wanted to be a geriatric doctor, Dr. Wasserman made a joking admission that he was “born an old man”—which he later remarked is a common thread among many people that end up working with older adults. I really resonated with this. It seems like many of us who enjoy working with older adults have had multiple positive experiences with them in our own lives. He later spoke to the dangerous impacts of ageism, which brought me back to the idea of why certain people decide to go into geriatric medicine.

If there’s one thing I think could really bolster the national policy response to eldercare, it would be combating ageism. In other words, instilling in our youth-obsessed society that older adults are holders of a lot of generational wisdom and history, and that their wellbeing matters. Policy reflects priorities, and until the crippling problems with eldercare in the U.S are brought to the front, effective policy is unlikely to emerge.

Dr. Wasserman decided in his third year of medical school that he wanted to go into geriatrics but ended up diversifying later in his career with a gig as CMO and then CEO of Rockport Healthcare Industries—the largest nursing home chain in California.

Effective Nursing Home Reform 

This experience gave him the kind of unique perspective that few doctors are able to receive. Dr. Wasserman was able to speak to what he believes is the real obstacle to nursing home quality improvement, which is not poor administration but the larger hand at play. Criticism of the nursing home industry should really be criticism of the money in the industry, and not nursing staff or administration, who work tirelessly, generously, and with very little pay. So when talking about ways in which to elevate care in the nursing home industry, he pointed out that the profit in the nursing home industry exists in private equity and real estate, not in operations. In other words, when nursing home operators say that they need money, it’s wise to believe them. 

Dr. Wasserman also spoke of the impact of COVID-19 on nursing homes and elders. In his eyes, the key to managing a crisis of this type lies with the nursing home infection preventionist, which every nursing home has. But when talking about the crisis response on a national level, he minced no words, positing that the U.S. response to COVID-19 will likely be regarded as the worst crisis management example in the history of the country. It’s devastating to me that it took the loss of hundreds of thousands of lives, disproportionately from the most vulnerable populations in America, to bring the many problems in medical care access to light. On the other hand, I can’t help but think that sometimes, the largest transformations require the most massive catalysts. 

The Future of Eldercare 

In response to poor healthcare policy, grassroots activism has been especially effective—geriatricians and eldercare experts have been featured in news publications large and small, voicing opinions that have been needed to be heard for a while. But as Dr. Wasserman pointed out, the real impact is at a policy-making level, and few of these types of positions in government are held by geriatricians or eldercare experts. Until that happens, the fight for improved policies and funding to elevate nursing homes and eldercare is stacked, but certainly not insurmountable. 

If there’s one thing I took from this podcast, it’s that there’s no reason to be pessimistic about the future of eldercare. If anything, after COVID-19, there’s a momentum driving the need for change that many experts in the field are riding on.