By Gail Kalinoski, Contributing Reporter
The number of Americans older than 75 will reach about 31 million by 2030, but it's not clear where the specialists will come from to meet their medical needs.
There are about 7,000 practicing in the United States now, and that number is not increasing at the rate of the aging population. The American Geriatrics Society estimates medical schools will have to train at least 6,250 more geriatricians between now and 2030 – about 450 more each year than the current number.
The problem is geriatricians — physicians who receive certification in internal or family medicine who have completed additional training in the care of older people — rank as the last specialty internal medicine residents choose to pursue. The chances of those ranks increasing significantly by 2030 appear slim.
Part of the problem is that even though extra training is required, the average salary of a geriatrician compared to an internist is about $20,000 lower. In fact, according to a report
in the New York Times it’s one of the lowest paying medical specialties. The median annual salary of a geriatrician in 2014 was $220,000 while the typical cardiologist made twice that in a year, according to the Medical Group Management Association.
Reimbursement rates from Medicare are also making it difficult to sustain a geriatric practice.
“Medicare disadvantages geriatricians at every turn, paying whatever is asked for medications and procedures, but a pittance for tough care-planning,” Dr. Joanne Lynn, a geriatrician and director of the Center for Elder Care and Advanced Illness at Altarum Institute in Ann Arbor, Mich., told the Times.
The AGS is pushing for additional funding to provide education for future geriatricians, said Nancy Lundebjerg, CEO of the New York-based AGS. She also
told U.S. News & World Report that the non-profit organization is focused on helping current physicians improve skills and knowledge needed to care for aging patients. The group has a program called the Geriatrics-for-Specialists Initiative that has worked with surgeons on developing guidelines on post-operative delirium and making emergency departments more receptive to the needs of older adults.
Other assistance comes from federal grants such as the $2.55 million recently received by the Institute for Sustainable Health & Optimal Aging at the
University of Louisville to help bring health care to rural and underserved older residents of six Kentucky counties. The three-year Kentucky Rural and Underserved Geriatric Interprofessional Education Program will help provide specialized geriatric training for UofL students and those already working with the elderly. The population of those counties 65 and older is expected to increase 149 percent by 2050, which is 35 percent higher than the same group in Kentucky and the U.S.
The grant will develop an education center at the university for students and professionals in medicine, nursing, social work, dentistry, pharmacy, community health and law. It will also help primary care sites deliver integrated care and provide training and community resources for those in the communities.
“We are going to use a systemic approach of collaborative care and develop an interagency consortium that strengthens the links among related services for older adults,” Dr. Anna Faul, executive director of the institute, said in a press release about the grant.
Reports also emphasize the importance of training various health care professionals, not just geriatricians, to handle the care of older patients. In some cases, mini-fellowships at teaching hospitals have also begun to add more training in geriatrics to practicing physicians.
