Despite
aging U.S. population, few physicians specialize in treatment
for the elderly
[Oct 18, 2006] -- Even as the "population ages and more people
... need them ... geriatricians are in short supply," the
New York Times
reports.
According to the Times, geriatrics "is a specialty of
little interest to medical students because geriatricians are
paid relatively poorly and are not considered superstars in an
era of high-tech medicine."
There was one geriatrician for every 5,000 U.S. residents
older than age 65 in 2005, and of 145 medical schools
nationwide, only nine have geriatric departments. In
addition, "teaching hospitals graduate internists with as
little as six hours of geriatric training," the Times
reports.
Geriatrics is a specialty "about managing, not curing, a
collection of chronic conditions"; "balancing the risks and
benefits of multiple medications"; and trying "nonmedical
solutions," according to the Times.
Such "common-sense remedies" exist in a health system that
"rewards the heroics of specialists in both compensation and
prestige," the Times reports, noting that the "best paid
doctors are those who do the most procedures."
Radiologists and orthopedic surgeons, for instance, have
average annual incomes of $400,000, compared with $150,000
for geriatricians. One possible solution to the shortage is
for geriatricians to limit their practice to the most
delicate elderly patients, those older than 85 and those 65
to 85 who have complicated conditions.
"Another solution, gaining a foothold among the nation's top
academic geriatricians" is to teach the primary principles of
the specialty to all doctors "because it is unrealistic to
assume there will be enough geriatricians to go around," the
Times reports.
Leo Cooney, a professor at
Yale University School of Medicine,
said, "If we got to the point where everybody in the health care
system was an expert in caring for older people, we wouldn't
need geriatricians. Or we wouldn't need them as frontline
providers. We'd be like consultants, making sure everyone else
was as skilled as possible" (Gross, New York Times,
10/18).