Lack of Incentive Means Fewer Physicians for the Elderly
by Shon Ingram
There is currently little incentive to encourage established doctors or students in medical school to specialize in geriatric medicine. Even though it is a recognized specialty, according to the American Geriatrics Society, there are only about 9,000 M.D. Geriatricians and several hundred osteopathic physicians (DO) certified in geriatrics, as well as some 2,400 board-certified geropsychiatrists in the United States. (A geropsychiatrists it is a psychiatrist trained to deal with the mental health needs and specific syndromes faced by older adults). Out of 145 medical schools in the United States only five have geriatric care departments. Many more medical schools offer elective courses in geriatrics but only 3% of all medical students ever enroll for such classes. According to the statistical abstract of the United States there are approximately 770,000 practicing doctors of medicine in the United States. This means there is roughly 1 doctor, including specialists, for every 300 persons in the United States. Based on the number of available geriatricians, there is only about 1 Geriatrician for every 3,000 elderly persons in this country. Because there are so few of them, it may be impossible to find a physician specializing in geriatric care in some areas of the country. Helping elderly people who are nearing the end of their lives and who suffer from multiple, incurable and chronic disorders is often not an appealing prospect to family doctors or to young medical students. Besides, geriatric care typically does not produce as much income as other specialties. Most doctors who treat the elderly are reimbursed either through Medicare or sometimes through Medicaid or sometimes a combination of both. These government programs have become more stingy over the years. Many doctors who in the past have accepted Medicare find that they have better paying opportunities treating younger patients and as a result they will no longer accept new Medicare patients. And as long as those younger patients are available for treatment, few doctors are going to go out of their way to seek out Medicare or Medicaid reimbursement. Fortunately, there are family physicians or internists -- non-geriatricians -- who specialize in treating older people and from experience they have probably learned many of the issues associated with treating the elderly, but many of these practitioners could probably benefit from more specialized geriatric training if it were available. Many doctors, geriatric nurse practitioners or physicians' assistants derive satisfaction from working with older people. They are likely taking a cut in pay by doing this. An older person or his or her family should seek to find these geriatric care specialists or if that is not possible, an effort should be made to locate a geriatric clinic in the area. Geriatric clinics are becoming more popular and they are likely to be well aware of the problems associated with treating elderly people. Many geriatric clinics include a team of specialists to help older people.