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"Those who work in geriatric care are among the worst paid in the health care system. Is the time I spend as a surgeon excising a patient's cancer worth 10 times more than the time the primary care doctor spent finding the cancer in the first place?" Dr. Gawande, who examined the problems of medical care for the aged last year in The New Yorker, pointed out that as we grow older, "we don't get one problem at a time." "People with multiple problems need time, and that is not cheap and is currently not paid for by medical insurance," he said. "It's not possible to address five different problems in a 20-minute visit." Dr. Gawande, who examined the problems of medical care for the aged last year in The New Yorker, pointed out that as we grow older, "we don't get one problem at a time.... People with multiple problems need time, and that is not cheap and is currently not paid for by medical insurance," he said. "It's not possible to address five different problems in a 20-minute visit."