The U.S. Census Bureau estimates the number of elderly Americans will nearly double to 71 million, or about 20% of the population, by 2030. The United States currently has about 800,000 doctors, and only 7,000, or about 0.8%, have special training in the care of the elderly. If the percentage of geriatricians stays the same over the next 20 years, the United States will have a shortage of 36,000 geriatricians by 2030.
According to a recent article on the coming "silver tsunami" , geriatrics has never been a field of choice for young doctors because of lower pay, less prestige among peers, and patients who are more difficult to treat, Medical schools and private organizations are sounding the alarm. More schools are adding geriatrics classes and training to their curricula, according to another article about how medical schools are now emphasizing geriatrics, so that every medical student regardless of specialty will understand how to care for the elderly. Private organizations are also donating money to establish new geriatric departments, increase geriatric content at existing programs, and offer more training.
The looming shortage of geriatricians is troubling. Nursing homes and assisted living facilities often turn to geriatricians for help with the care of their patients on such issues as medication management and the proper treatment of pressure ulcers (also known as pressure sores, bed sores, decubitus ulcers). Geriatricians are also often intimately involved in the administrative aspects of nursing home and assisted living care, including the preparation of clinical policies and procedures that guide the prevention and treatment of virtually every type of illness and condition common to patients at these facilities.
If geriatricians are impossible to find, if there is such a shortage that they are stretched too thin, or if nursing homes and assisted living facilities are left to their own profit-seeking devices without the resistance that's often offered by specialists, we're going to see a lot more nursing home and assisted living neglect and abuse -- severe pressure ulcers, sudden weight loss, malnutrition, dehydration, and medication errors, to name just a few.
Hopefully, the law of supply and demand will soon correct the current shortage. That is, as the population of older Americans grows, geriatricians will be in greater demand. When geriatricians are in greater demand, their incomes will increase. When their incomes increase, prestige among their peers will increase, all of which will prompt an increase in the number of physicians who want to be geriatricians. Until the laws of economics take over, the efforts of medical schools, private organizations, and others to highlight the coming "silver tsunami" should be commended. Let's just hope these efforts aren't too little too late . . .
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.
Posted on Wed, January 30, 2008
by Robert Carter