The article by Tillou et al1 is one of few that describe the use of a dedicated geriatric surgery consultation service. I know because I published observations from the first one in 1995.2 Our service was dedicated to the surgical care of nursing home patients, while Tillou and colleagues’ was focused on those admitted after traumatic injury. While the need for specialty care for both these populations at risk is intuitive, the reason why geriatric-focused surgical services have not grown is not.
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