Training Physicians in Geriatric Care: Responding to Critical Need
Training Physicians in Geriatric Care: Responding to Critical Need
Greg O’Neill Patricia P. Barry As the nation’s older population grows, the U.S. will require a well-trained workforce of health care providers with expert knowledge in geriatric medicine. Compared with younger adults, older Americans use a disproportionately larger share of health care services provided by physicians, nurses, pharmacists, physical therapists, and other practitioners. While people over age 65 represent 12 percent of the U.S. population, this group consumes one-third of healthcare services and occupies one-half of all physician time. Unfortunately, only a small share of the 650,000 medical doctors in practice today—including specialists whose patients are disproportionately elderly—receive the necessary training and education in geriatrics to provide older Americans with the best possible care.
Only three of the nation’s 145 medical schools physician visits each year (see Figure 1). have a full-scale department of geriatrics that requires As a result, though adults 65 and older made up a mandatory rotation in geriatrics for students and only 12 percent of the population in 2000, they made residents, and less than 3 percent of all medical students 24.3 percent of all office visits that year—about 200.3 take even one course in geriatrics. In contrast, every million visits, according to the National Center for medical school in Great Britain and 19 of Japan’s 88 Health Statistics. About 45 percent of all visits were medical schools have such a department (ILC, 2001). A made to primary care physicians (see Figure 2). mandatory geriatrics rotation in all U.S. medical schools For most medical specialists, the elderly represent would be welcomed, but a disproportionate share it would not solve the of their practices (see Figure 1 Average Number of Physician problem. Indeed, even if Table 1). For family Visits Among Older Adults, 1999 practitioners, 20.4 all of the 16,000 medical students who
Greg O’Neill Patricia P. Barry As the nation’s older population grows, the U.S. will require a well-trained workforce of health care providers with expert knowledge in geriatric medicine. Compared with younger adults, older Americans use a disproportionately larger share of health care services provided by physicians, nurses, pharmacists, physical therapists, and other practitioners. While people over age 65 represent 12 percent of the U.S. population, this group consumes one-third of healthcare services and occupies one-half of all physician time. Unfortunately, only a small share of the 650,000 medical doctors in practice today—including specialists whose patients are disproportionately elderly—receive the necessary training and education in geriatrics to provide older Americans with the best possible care.
Only three of the nation’s 145 medical schools physician visits each year (see Figure 1). have a full-scale department of geriatrics that requires As a result, though adults 65 and older made up a mandatory rotation in geriatrics for students and only 12 percent of the population in 2000, they made residents, and less than 3 percent of all medical students 24.3 percent of all office visits that year—about 200.3 take even one course in geriatrics. In contrast, every million visits, according to the National Center for medical school in Great Britain and 19 of Japan’s 88 Health Statistics. About 45 percent of all visits were medical schools have such a department (ILC, 2001). A made to primary care physicians (see Figure 2). mandatory geriatrics rotation in all U.S. medical schools For most medical specialists, the elderly represent would be welcomed, but a disproportionate share it would not solve the of their practices (see Figure 1 Average Number of Physician problem. Indeed, even if Table 1). For family Visits Among Older Adults, 1999 practitioners, 20.4 all of the 16,000 medical students who
References: Alliance for Aging Research. (2002). Medical Never-Never Land: Ten Reasons Why America Is Not Ready for the Coming Age Boom. Washington, DC: Alliance for Aging Research. Barry, P. (2002). The Critical Role of Practicing Physician Education. Paper presented at United Nations Second World Assembly on Ageing, Madrid, Spain. Centers for Disease Control and Prevention. (2000). The Costs of Fall Injuries Among Older Adults. Available at http://www.cdc.gov/ncipc/factsheets/ fallcost.htm Cohen, H.J. et al. (2002). “A Controlled Trial of Inpatient and Outpatient Geriatric Evaluation and Management,” New England Journal of Medicine 346, no.12: 906-912. General Accounting Office. (1995). Prescription Drugs and the Elderly. GAO: Report Number HEHS95-152. Geriatric Care Act of 2003. For more information see http://thomas.loc.gov International Longevity Center. (2001). A National Crisis: The Need for Geriatrics Faculty Training and Development. New York: ILC USA, Ltd. Kovner, C.T. et al. (2002). “Who Cares for Older Adults? Workforce Implications of an Aging Society,” Health Affairs, September/October, 78-89. Medicare Payment Advisory Commission. (1999). Rethinking Medicare’s Payment Policies for GME and Teaching Hospitals. Washington, DC: MedPAC. Oxman, T. and A. Dietrich. (2002). “The Key Role of Primary Care Physicians in Mental Health Care for Elders,” Generations (Spring Issue). Volume 13, No. 2 Public Policy and Aging Report Page 21