As Baby Boomers get older, doctors for them dwindle

U.S. shortage of geriatricians expected to get worse

11/8/2011

PALATKA, Fla. — In this riverside town in Florida, 86-year-old Betty Wills sees the advertisements of obstetricians and gynecologists on the main road’s billboards and has found specialists ranging from cardiologists to surgeons in the phone book.

But there’s not a single geriatrician — a doctor who specializes in treating the elderly — in all of Putnam County, where a fifth of the county’s 74,000 people are seniors.

“I looked,” Ms. Wills said. “I didn’t find one.”

The shortage is nationwide, and it’s going to get worse as the 70 million members of the Baby Boom generation — those now 46 to 65 — reach their senior years over the next few decades.

The American Geriatrics Society says the nation has roughly one geriatrician for every 2,600 people 75 and older. Without a drastic change in the number of doctors choosing the specialty, the ratio is projected to fall by 2030 to one for every 3,800 older Americans.

Compare that to pediatricians: about 1 for every 1,300 Americans under 18.

Good geriatricians understand how an older person’s body and mind work differently. They listen more but are paid less than their peers. They have the skills to alleviate their patients’ ailments and help them live fuller, more satisfied lives.

Though not every senior needs a geriatrician, the specialty’s training often makes the practitioners the best equipped to respond when an older patient has multiple medical problems. Geriatricians have expertise in areas that general internists don’t, including changes in cognitive ability, mood, gait, balance, and continence, as well as the effects of drugs on older individuals.

But with few doctors drawn to the field and some fleeing it, the disparity between the number of geriatricians and the population it serves is destined to grow even starker.

“We’re an endangered species,” said Dr. Rosanne Leip- zig, a renowned geriatrician at Mount Sinai Medical Center in New York.

Just 56 percent of first-year fellowship slots in geriatrics were filled last academic year, according to a University of Cincinnati study, and the number of physicians on staff at U.S. medical schools’ geriatric programs has generally been trending downward.

Many young doctors aren’t receiving even basic training in caring for older patients. Fifty-six percent of medical students had clinical rotations in geriatrics in 2008, according to the study.

Karen Roberto, director of the Center for Gerontology at Virginia Tech, said doctors who aren’t trained in geriatrics might have a tendency to discount an older person’s problems as normal symptoms of aging, when in fact they can be treated. “Going from specialist to specialist is not the answer. Older adults need providers with comprehensive knowledge of their problems and concerns.”