The changing medical needs of the growing
65-and-over population in the United States are not being met by
current medical education, UC researchers warn.
What is required, they say, is more standardized geriatric training in all medical specialties.
An article in the March 2005 issue of
Academic Medicine says older adults are making more visits to
nonprimary-care specialists, and suggests faculty development and
curriculum changes be made to better prepare future physicians to
handle this growing patient base.
In 2001, 53 percent of ambulatory
(outpatient) visits by patients 65 and older were to nonprimary-care
specialists, an increase of 13 percent from 1980.
"Until recently, most physician visits by
geriatric patients were to primary-care providers," says lead author
Elizabeth Bragg, PhD, of UC's Institute for the Study of Health. "The
changing needs of the geriatric population have shifted that trend.
Now, more than 50 percent of all outpatient visits by geriatric
patients are to nonprimary-care specialists."
The authors reviewed program requirements
of 91 specialties accredited by the residency review committees of the
Accreditation Council for Graduate Medical Education (ACGME). They
found, as of 2003, that only 27 of the 91 specialties had specific
geriatric training requirements. And these requirements, say the
authors, have very modest expectations.
"In other words," they say, "70 percent
of the graduate medical education specialties training nonpediatric
physicians do not have specific geriatrics curriculum requirements. Yet
once these physicians establish their clinical practices, many adults
over the age of 65 will become their patients."
It is estimated that by 2030 there will be more than 70 million people over the age of 65 in the United States.
"We know there's a shortage of trained
geriatric specialists," says co-author Gregg Warshaw, MD, professor of
geriatric medicine and family medicine at UC. "It only makes sense that
we improve geriatric education within medical specialties in order to
achieve a well-trained physician workforce prepared to handle the
medical needs of this population."