5 things to know about the national crisis facing aging Americans

As a society, Americans are obsessed with aging — how to age slower, better, healthier. Yet as this obsession bleeds into healthcare through discussions on palliative care, hospice and advanced directives, it is becoming increasingly obvious we — healthcare professionals included —don't know nearly enough about aging.

"Most healthcare professionals have had little to no training in the care of older adults. Currently, 97 percent of all medical students in the United States do not take a single course in geriatrics," a recent article in The New York Times reads.

This lack of knowledge combined with the aging Baby Boomer population has the makings of serious national crisis.

Here are five things you need to know about the national aging crisis.

1. There is a national shortage of geriatricians. According to The New York Times, there are currently less than 8,000 geriatricians. Yet the population of Americans over age 65 is growing, so that by 2050, a projected 90 million Americans will be over age 65 and a projected 19 million will be over age 85. The report crunched the numbers and estimated that by 2030 there will be one geriatrician for every 3,798 older adults. The American Geriatrics Society says there should be one geriatrician to every 300 older adults in an ideal world, according to the report.

2. Geriatrics is not a lucrative specialty. Most geriatricians are reimbursed by Medicare and Medicaid, making it difficult to sustain a financially viable practice. According to an NPR report, geriatricians made an average salary of $184,000 in 2010, which was nearly three times less than radiologists. Students often look for higher-paying fields to help offset the burden of medical school debt. According to a 2015 Medscape report, 78 percent of medical residents have some debt, and 37 percent of residents have more than $200,000 in debt. High levels of debt and low pay can make geriatrics less appealing to medical students.

3. Geriatric patients are managed, not cured. Medical students may also shy away from geriatrics because their patients tend to be medically complex and have diseases that cannot be cured. In combination with low-pay, geriatric cases tend to be more time consuming, according to the NPR report.

4. All specialties work with elderly patients. Geriatricians are not the only type of physicians that will be in contact with older patients, yet as previously stated, 97 percent of medical students do not take a single course in geriatrics. An orthopedic surgeon, for example, will likely see a lot of older patients. According to the NPR report, more than 400,000 patients over age 80 had a knee replacement last year Orthopedic surgeons and geriatricians aren't alone. Cardiologists, ophthalmologists and many other specialties also have significant numbers of older patients. It is critical all medical students are trained to work with elderly and aging patients.

5. Some medical schools are working to help prevent the crisis. The nation needs about 30,000 geriatricians by 2030 to serve the aging population, according to data in the NPR report from the American Geriatrics Society. For medical schools to meet this need, they would have to train 1,500 geriatricians every year until 2030, which, according to NPR, is five times as many as last year. However, the report focuses on Cleveland-based Case Western Reserve School of Medicine's current initiative to expose more students to older patients. Students in Case Western's medical school sat in on a panel discussion of older people, ages 90 and up, as they discussed their experiences with the healthcare system, in the hopes increased exposure will help students understand the importance of geriatrics and incorporating geriatrics into their practice.


More articles on integration and physician issues:

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Family physicians play critical role in ED care in urban hospitals

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