CINCINNATI—The older population may soon be facing a medical care crisis as numbers of students studying geriatric medicine continue to decrease rapidly, say researchers at the University of Cincinnati.
It is estimated that by the year 2030, there will be more than 70 million people over the age of 65 in the United States.
According to the data collected over the last decade, the number of certified geriatricians in the United States has declined from 8,800 to 7,100.
“The population of doctors who are trained to deal with problems of aging people is dropping dramatically,” said Elizabeth Bragg, PhD, of UC’s Institute for the Study of Health and co-investigator of the study, adding that trends in the data revealed that numbers will continue to decrease.
Results showed that from 1999 to 2006, the percentage of people entering family medicine or one of its subspecialties, including geriatrics, has dropped 6.3 percent.
Only 67 percent of positions in fellowship programs, needed for geriatric students to graduate, were filled during 2005–06.
The National Institute of Medicine is now using this data as it begins studying the health care workforce for older Americans and targeting the needs of the older population. The study is set to be completed in March 2008.
Bragg said one reason for the decline of geriatric students is money.
“On average, in 2006 total medical student debt was around $113,000,” she said, adding that geriatric students must also take an extra one to three years of training on top of their normal residencies. “Geriatric doctors’ salaries are much lower than many other medical specialties, and students with considerable debt are more likely to choose a higher paying specialty.”
“Students see better pay and more predictable work schedules as an incentive to stay away from geriatrics.”
Aside from more work and a smaller paycheck, Bragg said the reason students don’t want to go into geriatrics is simple.
“Most people think working with older adults is depressing,” she said. “Also, the procedures aren’t as ‘glamorous’ as in other specialties. There needs to be a big shift in attitudes when it comes to care for the older population. In fact, a recent survey of physician satisfaction demonstrated that geriatricians are actually more satisfied with their work than other specialists.”
Bragg added that more standardized geriatric training is needed across all medical specialties.
Anywhere between 20 to 50 percent of ambulatory visits to physicians are by patients aged 65 and older. But according to the study, almost 25 percent of medical students in 2005 viewed their geriatric instruction as “inadequate.”
“Residency requirements have little or no specifications for geriatrics,” said Bragg. “There needs to be a move to incorporate this training into all areas of medicine.
“Many people think caring for the older population is no different than family medicine, but older people often need special care.”
In 2000, UC’s Institute for the Study of Health was commissioned by the Association of Directors of Geriatric Academic Programs—funded by the Donald W. Reynolds Foundation—to conduct a longitudinal study of training and practice in geriatric medicine. This research partnership was renewed in 2002 with further funding from the Reynolds Foundation.
In February 2006, the John A. Hartford Foundation joined the Reynolds Foundation in funding three more years of the workforce study.
For more information on the research to date, visit www.adgapstudy.uc.edu.