Who Will Take Care of Us As We Age?

Yes, the baby boomer generation is here and the American Geriatrics Society (AGS) is starting to take notice. Where will we find the workforce to care for the aging population? Most doctors are not prepared, and this will leave a large portion of the care to retired doctors that don't want to work. I presently know two doctors that have reentered the medical community to help care for their elderly friends and others of the elderly.

Have they had the training? No! Like one of them says, but neither does the rest of the medical community in this area. He continued that many in today's medical profession do not want the elderly patients. He said that he found this out shortly after he retired and could not find a doctor to treat him. In the past, young doctors took good care of the older doctors, retired or not. Today, the young doctors are not interested and only want younger patients.

The author of this blog says, “Most residency education in the US is funded through Medicare. Given Medicare’s charge is primarily to care for adults over 65, you would think that Medicare would emphasize training physicians to meet the needs of an aging population. Yet the statement that sticks with me from AGS is this: “10,000 new beneficiaries enroll in Medicare every day, yet we lose 5 geriatricians every week.””

The author, Paul Tatum, goes on to say, “Moreover, the additional trends in geriatric education actually point to less support for training physicians to care for older adults. The Reynolds Foundation, which has been a tremendous supporter, is a foundation designed to spend down its assets and will soon no longer be a source for innovative grants to improve delivery of care to older adults. Likewise, the main grant for training geriatrics clinician educators, the Geriatric Academic Career Award, will not be funded by the Health Research Services Administration this year. How will we create the clinicians that we need for our future without support for the educators who will teach them?

The National GPS Corps (National Geriatrics and Palliative Service Corps) should consist of three elements:

1. To promote geriatric or palliative care training, all residents who complete a geriatric or palliative care fellowship shall have half of their student loan burden relieved through federal debt forgiveness or payment to private lenders. Crushing student debt is a key factor driving trainees to higher paid specialties and this will make geriatric and palliative care training more feasible. 
2. To promote excellent geriatric and palliative care academicians, those who opt for a second year of additional academic or research training will have all subsequent student loans forgiven or paid.
3. To promote clinicians practicing in geriatrics and palliative care rather than further specialty training and to allow for appropriate geographic distribution across the country, those who only complete one year of fellowship will be eligible for further debt forgiveness after completion of a three or five year clinical commitment in a designated geriatrics/palliative care service area.

I agree that teachers must be created to train the workforce needed to care for the elderly. Congress needs to act now to meet this need.