Consultation and Geriatric Psychiatrist, Riverside Health System
Anthony Caterine says he always knew he wanted to be a doctor: “My father was a surgeon, so I was interested in medicine early on.” He recognized early on that people seemed comfortable talking to him (he was elected president of his junior and senior classes in high school), and he chose psychiatry because he excelled in it in medical school (Stritch School of Medicine, Loyola University, ’88.) He completed his residency in psychiatry at Shand’s Teaching Hospital in Gainesville Florida in 1992. He also took specialized training in forensic psychiatry under Dr. George Barnard at the University of Florida. Dr. Barnard, he notes, was one of the Forensic Psychiatrists who evaluated Aileen Wuornos, the serial killer from Florida who was portrayed in the movie “Monster.” Dr. Caterine conducted 194 forensic psychiatric evaluations, and provided expert testimony in 30 court cases.
He began his career in a standard, inpatient/outpatient practice, being interested in both aspects. But as he got further into his career, he realized he had an affinity for working with patients in the more acute hospital setting.
He had joined a practice in the Midwest, but found himself gravitating more and more toward treating dual diagnosis patients, with acute physical and psychiatric problems. In 2002, Dr. Caterine took advantage of the opportunity to move to Virginia to work on a medical psychiatric unit, part of the Riverside Health System. “These patients were too medically ill to be in a regular psychiatric hospital,” he says, “but they still required intensive psychiatric treatment.”
When that unit closed, Dr. Caterine remained within the Riverside system. “Riverside has a very large, comprehensive lifelong health program,” he says. “They have a focused geriatric practice, with twelve nursing facilities as part of the system. They knew I was Board certified in Geriatric Psychiatry, so they asked me to start doing psychiatric consults there initially, while I continued doing consults at the general hospital.” He moved over to the lifelong health division, and since 2005, has confined his work to consults at several Riverside Hospitals and the various nursing facilities.
“The biggest change for me in the last couple of years has been telemedicine,” Dr. Caterine says. “I used to literally drive to all of the nursing facilities, which are all over the place. One year I logged more than 10,000 miles! Such an inefficient use of my time with so many patients needing treatment, patients I couldn’t physically get to.”
Today, through telemedicine, he’s able to do consultations at Riverside’s Tappahannock, Gloucester and Eastern Shore hospitals as well as the nursing facilities in similar areas. “With telemedicine, I can schedule my time, but can also do consults the same day they are asked, if indicated,” he notes.
His interest in and compassion for the concerns of severely ill and psychiatric elderly patients is reflected in the research he has done and the many presentations he has given, particularly in the areas of depression, bipolar disorders, geropsychiatry and geriatric psychopharmacology. He was recognized by J. C. Penney’s Partners in Peace Award for Contributions to Senior Strength Program Center for the Prevention of Abuse in 1997.
As a geriatric psychiatrist, Dr. Caterine believes passionately that society has a responsibility to better prepare for the number of people who will need treatment for dementia. “People are living longer and longer, and as we know, Alzheimer’s is a disease of aging. By the time these people are 85, they’ll have a 30-40 percent chance of developing Alzheimer’s. And the risk keeps going up after that.” With the Baby Boomers entering ages associated with dementia, there is going to be a significant increase in people with dementia. He sees these patients every day and many are happy and coping well. “But some are not,” he cautions, “and they can be very difficult to take care of. If we don’t think about this and plan, these people are going to fill up our ERs, hospitals, and then – because they will have nowhere else to go – the younger people who need treatment in those settings will have a harder time getting the treatment they need.”
Dr. Caterine enjoys finding novel ways to assess patients’ ability to engage with him, as a sign of possible depression or apathy. Lately, he’s been asking, “Who are you voting for president this year?” He finds it telling that many are replying, “No one.”