Wanted: 450 more geriatricians per year

If primary care is a tough draw, getting medical students interested in geriatrics is nearly impossible. It's a state of affairs that's expected to only get worse as the population ages, according to an article from The New York Times.

The United States currently has only about 7,000 practicing geriatricians to serve a projected need of 30,000 by 2030, or about 450 more each year, FiercePracticeManagement reported previously.

Despite the need for physicians trained to manage the problems of old age such as dementia, delirium, fall risk and a host of chronic conditions also seen in middle age, there are several reasons the field has low appeal.

For starters, the extra two years of training that geriatricians must undergo after becoming certified in internal or family medicine does not yield better compensation, the article noted. The median yearly salary of a geriatrician in private practice was $220,000--less than half of a cardiologist's pay--in 2014, according to data from the Medical Group Management Association.

"Medicare disadvantages geriatricians at every turn, paying whatever is asked for medications and procedures, but a pittance for tough care planning," explained Joanne Lynn, M.D., a geriatrician and the director of the Center for Elder Care and Advanced Illness at Altarum Institute, a nonprofit health systems research organization based in Ann Arbor, Michigan.

The other key barrier is a perception among physicians that the cumulative problems patients suffer in old age can't be fixed, Kenneth Brummel-Smith, M.D., a professor of geriatrics at Florida State University College of Medicine in Tallahassee, Florida, told the NYT. 

But curing disease isn't necessarily the objective of a geriatrician so much as promoting quality of life. In many instances, this means focusing on details such as hydration, nutrition, social support, mobility and medication management.

It's not just patients who stand to benefit from this approach. Recent evidence about care provided by geriatrics teams shows that they can help shorten hospitalizations for older adults, lower costs, and reduce complication such as falls, pressure ulcers and urinary tract infections, according to the newspaper.

As these relationships come into sharper focus, opportunities may emerge for other professionals, such as nurses, pharmacists and physical or occupational therapists, to receive specialized training to help guide patients through old age, NYT noted. 

To learn more:
- read the article