The Problem
In less than 15 years from now, one fifth of our population will be people 65 and older, and 90% of that population will have one or more chronic conditions to care for. With older age comes the potential for additional health problems and thus a need for additional care from geriatric physicians. The definition of old age does not mean what it used to, people today are living much longer, with men having an average life expectancy of 84 years, while women now have an average life expectancy of almost 87 years. However, with the rapidly growing aging class, there will not be enough geriatricians to supply the need that is quickly looming. Currently, there are roughly 7,000 geriatricians in the United States, a record shortage in the country’s history, and about half of what will be required to adequately address the needs of aging individuals. While regular physicians can treat some of the conditions that the older population faces, their issues are unique and will require specific attention, such as hypertension, arthritis, heart disease, diabetes, osteoporosis and dementia.
Why the Shortage?
Geriatricians are internal or family medicine doctors who also become specialized in care for older adults and the elderly. While the demand is incredibly high, part of the reason for the shortage is due to the average income being so incredibly low as compared to other specializations. Geriatricians still require additional training past that of general internists but are not compensated accordingly. The lower ended salary is generally a result of many older patients having health care covered through Medicare, which has a low reimbursement rate and has been plagued by problems.
Is There a Solution?
As a result of the lack of interest in being a geriatrician, the medical field is attempting to address the problem by having professionals, including nurses, pharmacists, and doctors already specializing in areas such as cardiology and oncology, participate in programs and short fellowships that allow them to assess older adults needs in their area of care instead of specializing as a geriatrician. This specific training for older adults may help combat the rising need for geriatricians to some degree over the next few decades and has been funded through projects such as the American Geriatrics Society and the Geriatrics-for-Specialists Initiative.
The Initiative works to help release guidelines and tools for specializing doctors and has seen noted success with the release of their guidelines for surgeons on post-operative delirium in the aging population. It is also important for doctors to focus on holistic care for older adults, since so many of them will end up managing multiple conditions at one time. Having their physicians, as well as nurses, social workers, occupational therapists and physical therapists communicate can be key in aiding in recovery and managing long term care.