“The nation’s shortage of geriatricians is no secret. The prestigious Institute of Medicine highlighted the shortage in a 2008 report, and the American Geriatrics Society has projected the nation will need 25,000 geriatricians by 2025, or about three times the 7,000 geriatricians currently certified.”
Well, once the Death Panels get rolling, they won’t be needed much.
Atul Gawande interview about Geriatricians
Does anybody clamor for geriatricians? We’ve had a drop from 1998 to 2004 in the number of geriatricians in our country, by one-third. At a time when the number of elderly are increasing enormously. In just a decade we’re going to be a 20% of the population being over the age of 65.
Now part of the reason people don’t clamor for the geriatrician is what the geriatrician does. What the geriatrician does is they don’t make your life longer, they help figure out how to be attentive to your nutrition, and whether your toenails are clipped and whether you have good balance and whether your strength is there, and whether you’re exercising, and whether your eyes are doing well. All the things that you need in order to stay independent, to have control over your life.
And so there was a randomized trial in Minnesota that showed that the likelihood that under geriatricians’ care, as opposed to the usual primary physician for these elderly patients, the likelihood that they would have a disability dropped by 25%. The likelihood they developed depression dropped by 50%. But they didn’t live any longer. And so what we’ve had is the gradual disappearance of geriatrics as a profession and almost no outcry about that.
And so my answer to what do we do about it? Well the reasons why geriatricians are disappearing is in part because we don’t pay them very well, it’s one of the lowest-paid professions compared to becoming a radiologist, becoming a surgeon like I am. Another reason is because it’s not glamorous work, taking care of older people with lots of different problems, arthritic knees, a tumor they might have developed, bad back pain, diabetes, high blood pressure, and them somehow helping them live and stay at home as long as possible.
But if we value it, we actually would transform what it’s like to age.
His 2007 article on The Way We Age Now in The New Yorker is the best article you will ever read on the subject
Americans haven’t come to grips with the new demography. We cling to the notion of retirement at sixty-five—a reasonable notion when those over sixty-five were a tiny percentage of the population, but completely untenable as they approach twenty per cent. People are putting aside less in savings for old age now than they have in any decade since the Great Depression. More than half of the very old now live without a spouse, and we have fewer children than ever before—yet we give virtually no thought to how we will live out our later years alone.Posted by Jill Fallon at February 19, 2013 9:07 PM | Permalink
Equally worrying, and far less recognized, medicine has been slow to confront the very changes that it has been responsible for—or to apply the knowledge we already have about how to make old age better. Despite a rapidly growing elderly population, the number of certified geriatricians fell by a third between 1998 and 2004. Applications to training programs in adult primary-care medicine are plummeting, while fields like plastic surgery and radiology receive applications in record numbers. Partly, this has to do with money—incomes in geriatrics and adult primary care are among the lowest in medicine. And partly, whether we admit it or not, most doctors don’t like taking care of the elderly.