ABSTRACT
Geriatricians have struggled to describe a complex and sometimes ambiguous professional identity. Unlike other medical specialties anchored in discrete organ systems, diagnostic and interventional technologies, or clearly defined clinical settings, geriatric medicine encompasses the care of a heterogeneous population of older adults with widely varying clinical needs, priorities, and trajectories relevant to function, multimorbidity, and complexity. This Special Article examines four distinct but overlapping perspectives on geriatrician identity—the complexivist, the healthful longevitist, the syndromist, and the contextualist. The complexivist perspective emphasizes expertise in managing multimorbidity, frailty, and the interplay of medical, functional, cognitive, and social challenges. The healthful longevitist reframes the discipline around extending healthspan, promoting resilience, and supporting healthy aging. The syndromist reflects a trend toward syndrome-specific specialization, such as “brain health,” in some respects, paralleling subspecialty evolution in other fields. The contextualist highlights geriatricians who center their work within specific care settings or models of care, including home-based primary care, skilled nursing facilities, PACE programs, ACE units, co-management models of care with other specialties, and Age-Friendly Health Systems. While each perspective offers valuable insights, none alone fully captures the breadth of geriatric medicine or resolves long-standing tensions around recognition, prestige, and the profession’s future. Debates over identity should not be viewed as divisive, but rather as essential to strengthening the profession. Continued examination of geriatrician identity is critical to ensuring that the specialty remains relevant, valued, and morally ambitious in the face of an aging population, major advances in geroscience and technology, and an evolving healthcare system.