I have over 12 years of managed care experience in providing guidance and consultative services to Utilization Management (UM) and Care Management (CM) staff and management on issues relating to clinical services, case management, condition management, and health risk assessments.
Dr. Pankaj Gupta, MD, MBA's Expert Contributions
The current healthcare system in America is fundamentally flawed. At the core of the health care system lies a perverse incentive to reward a high volume of services. This, in turn, can lead to more physician visits, which may lead to more procedures and tests, which could lead to more...
You should have your mother get checked out by a cardiologist right away. READ MORE
It's normal to go through a bereavement process. If the signs continue after 2 months, then it could be depression. READ MORE
Urinary incontinence can be because of many different reasons: infection, neuro-cognitive problems (dementia, Parkinson's), depression, arthritis (not being able to get to the bathroom), etc... We should find out the root cause. I suggest you visit your doctor. READ MORE
This could be Essential Tremor, which is not related to a disease process. I recommend that you get it checked out. A simple pill can take care of the issue. READ MORE
I suggest that your mother-in-law see a gynecologist. They may check the lining of the organ to make sure that everything is okay. READ MORE
Not very good wound healing may be because of a poor diet, underlying diabetes, or bad circulation. I recommend you go to your doctor. READ MORE
It could be an infection or impact ion of hard stools with diarrhea flowing around it. READ MORE
Please speak to your mother's doctor. The weight loss in only 3 months is quite significant. READ MORE
Yes, it makes people drowsy. READ MORE
I suggest not to give a medication until we know why is she becoming agitated. Is it at a certain part of the day, is it after something that sparked her to behave like that? Sometimes, agitation can be a simple urine infection. READ MORE
Parkinson's can affect even younger people. Michael Fox is an example... READ MORE
Depending on what was the extent of the infection in the lungs will factor in how long he might need oxygen support. Check with your doctor. If his resting oxygen level is above 88%, then the doctor should recommend taking him off oxygen (this is assuming your father has enough lung power to climb stairs, etc.). READ MORE
Absolutely not. Painkillers are NOT suitable for older people. Painkillers have a lot of side effects. It is important to know what is a safe dose. Painkillers should not be used chronically. READ MORE
Sorry to hear. There is a lot of research going on. Unfortunately, at this time, it is a progressive disease. Hopefully, the medication will control her symptoms. READ MORE
Your grandmother should really see her doctor. We must make sure that there is no infection. I would stay away from benedryl. READ MORE
We would rather not introduce another pill to his pharmacy regiment. I suggest making sure he drinks enough plain water and has high-fiber food like oranges, apples with the skin, figs, prunes, etc. READ MORE
My father is 82 years old and has been detected with a tumor in the stomach. Would it make sense to make him to go through the treatment?
We should consider how functional is your father? Can he care for himself? Can he drive? Is he active? How is his memory? Does he have health problems? Is the stomach tumor affecting his quality of life? READ MORE
I specialize in geriatrics (dementia, etc.) and I would think your current doctor that you see during your pregnancy would know and provide you with an accurate answer to your question. Good luck! READ MORE
Cauterization is a surgical practice of burning the tissue to remove a growth. Depending on what the tumor is would tell us what type of tumor it is and if it is fatal. READ MORE
YES, numbness can be caused by uncontrolled diabetes. It depends where the numbness is. The excess glucose in the blood affects the nerve endings, especially in the feet. READ MORE
My advice is to see your family physician. This could be a complication of diabetes. READ MORE
Shivering hands without any loss of muscle strength is probably not a sign of a stroke. Sometimes it could be an "essential tremor," which is not a serious condition. Please seek advice from your doctor. READ MORE
Yes, dryness of the skin is common. She can stay away from room heaters and other sources of dry heat. She can use cream to relieve the dryness. Make sure she is hydrated with water. READ MORE
I suggest that you visit your primary care physician. Fecal incontinence can be a side effect from a medication, a problem with the nerves going to the rectum, or something related to your colon. READ MORE
Constipation in the elderly is tricky because it's not the same treatment for someone a lot younger. For example, if someone younger takes Metamucil, then they should follow it up with a lot of water. But in the elderly, it's difficult to have a lot of water. So, I suggest prune juice for the elderly. If juice is not preferred, then I suggest 8 prunes throughout the day. I would stay away from iron supplements. Sometimes some medications that are commonly prescribed in the elderly have a side effect of constipation. Sometimes, the thyroid hormone is low and then the person gets constipated. I hope that helps. READ MORE
Yes, depression is common. Unfortunately, with the elderly, sometimes depression can be "masked" by memory loss from a simple urine infection or from dementia. My advice would be to get it checked out by a physician. There is a simple questionnaire that can be scored by the physician to diagnose depression. READ MORE
Check the fridge. Is she eating? Are her clothes clean? Does the house look dirty? Does she have a pet? Does your mom drive? READ MORE
Sometimes, Dementia (or memory loss) masks depression and depression can mask dementia. With the concomitant weight loss, I would suggest that your father see a geriatrician (or a physician that specializes in making sure our elders still function as much as possible). The geriatrician will perform a simple "memory check" by simply asking questions and scoring the answers. He/she will try to look at your father holistically by taking into account other medical conditions, what medications your father is on, and how much your father can do for himself. I hope this helps. READ MORE
I'm sorry to hear. Please call your grandfather's primary care physician. This sounds like this wound needs attention. READ MORE
Good question. I am glad you asked. We should make her environment comfortable and recognizable to her (even though she has dementia). Place objects that she is familiar with around her. Let's not look for medications right away... READ MORE
walking slower can mean a lot of things. It could mean that his vision might be affected. It could mean that he feels unstable when walking. It could be a condition like Parkinson's disease. I would definitely go to your doctor and have it checked out. All the best... READ MORE
Your father needs support. We don't want him to wander or fall. A geriatrician is a great idea. Depending on the social services that are available in your father's area, the geriatrician can better guide you. READ MORE
Often times, joints crack. This could be a normal process or can be because of some other process which needs a physician's attention. Before you go ahead with physical therapy, I would recommend getting it checked out with your physician. READ MORE
The concern for weight loss is real, but I would not recommend an appetite stimulant. Appetite stimulants will not increase muscle mass. It has not been shown to increase muscle mass. The more effective way is to hand-feed or even question any underlying depression...? READ MORE
Older people especially with underlying dementia are prone to a metabolic encephalopathy insult. READ MORE
- Albany Medical Center 6-Sigma Green Belt
What do you attribute your success to?
- Being a lifelong learner. Dr. Gupta has been at the forefront of effective managed care operations. As a geriatrician and administrator, he is keenly aware of the need for economically effective programs that also result in patient satisfaction in a continually-evolving health care system.
Hobbies / Sports
- Skydiving, Scuba diving
Favorite professional publications
- J. Health Affairs
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