Thirty-five years ago, Jerry Gurwitz was among the first physicians in the United States to be credentialed as a geriatrician — a doctor who specializes in the care of older adults.
“I understood the demographic imperative and the issues facing older patients,” Gurwitz, 67, chief of geriatric medicine at the University of Massachusetts Chan Medical School, told me. “I felt this field presented tremendous opportunities.”
But today, Gurwitz fears geriatric medicine is on the decline.
Despite the surging older population, there are fewer geriatricians now (just over 7,400) than in 2000 (10,270), he noted in a recent piece in JAMA. (In those two decades, the population of those 65 and older has expanded by more than 60%.) Research suggests each geriatrician should care for no more than 700 patients; the current ratio of providers to older patients is 1 to 10,000.
What’s more, medical schools aren’t required to teach students about geriatrics, and fewer than half mandate any geriatrics-specific skills training or clinical experience. And the pipeline of doctors who complete a one-year fellowship required for specialization in geriatrics is narrow. Of 411 geriatric fellowship positions available in 2022-23, 30% went unfilled.
The implications are stark: Geriatricians will be unable to meet soaring demand for their services as the aged U.S. population swells for decades to come. There are just too few of them.
“Sadly, our health system and its workforce are wholly unprepared to deal with an imminent surge of multimorbidity, functional impairment, dementia and frailty,” Gurwitz warned in his JAMA piece.
This is far from a new concern.
“Unless action is taken immediately,” a 15-year-old report from the National Academies of Sciences, Engineering and Medicine concluded, “the health care workforce will lack the capacity (in both size and ability) to meet the needs of older patients in the future.”
According to the American Geriatrics…
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