Trendspotter: Dealing with the Geriatrician Gap

February 3, 2011

When the calendar turned to 2011, the realization came with it that a whole generation of baby boomers were turning 65 and would lack specialists to address their eldercare needs. As many in the media have dubbed it, the United States is facing a "silver tsunami."

When the calendar turned to 2011, the realization came with it that a whole generation of baby boomers were turning 65 and would lack specialists to address their eldercare needs. As many in the media have dubbed it, the United States is facing a "silver tsunami."

This realization comes, however, as the nation faces a growing physician shortage in numbers in some areas, in distribution in others, both for children and for older adults. Current reports indicate there is one geriatrician for every 5,000 older Americans; and that thousands more specialists are needed to meet the aging population's needs in the next decade.

ABC News kicked off an excellent series this week entitled "Families on the Brink," exploring care for older Americans from the perspective of caregivers, most likely a child or relative. ABC cites the AARP in stating that there are nearly 66 million family caregivers in this country - 30 percent of the entire population - and 7 of 10 of them care for an older adult.

If you have time to watch the video series, I highly recommend it, including topics from prescription problems to end-of-life care. As a physician, it may be informative to hear what caregivers share with a video camera that they may not share with you during a visit for their family member.

But what to do about the lack of geriatricians in the U.S. to address both care and comfort needs and aid these caregivers?

Some medical schools are taking steps to educate students about eldercare issues. Take, for example, the University of Utah School of Medicine's geriatrics division. The school's Hospital Elder Life Program is incorporating both students and community volunteers to address the link between hospital-based delirium and recovery in the community.

New Jersey recently received a series of HHS grants including a five-year, $3.45 million award to fund fellowship training programs to prepare physicians and other healthcare providers in geriatrics as well.

But perhaps more needs to be done. In a Health Affairs article last year - entitled "The Urgency of Preparing Primary Care Physicians to Care for Older People with Chronic Illnesses - the authors suggest several changes in medical education policy. Among the suggestions are increased funding for medical schools when it comes to geriatrics; strengthening geriatrics in residency and fellowship programs via Medicare educational subsidies; and mandating practicing physicians to complete geriatric CMEs to maintain both Medicare provider certificates and their state license.

According to the ABC News special on aging, fewer than three percent of current physicians received one hour of training on geriatric issues.

The goal say the authors - including a pair of geriatrics professors - is for a better prepared and better educated physician workforce to meet the needs of our graying nation.

For current physicians, the AMA has even jumped in with assistance. Yesterday, the medical association unveiled its "Geriatric by Design" e-book, offering practice management tips and even office design recommendations to meet the needs of older patients.

So whether you are studying to be a physician, or are already one, you will surely see more tools, resources, and programs geared at helping older patients.