Even as the "population ages and more people ... need them ... geriatricians are in short supply," the New York Times reports.
According to the Times, geriatrics "is a specialty of little interest to medical students because geriatricians are paid relatively poorly and are not considered superstars in an era of high-tech medicine."
There was one geriatrician for every 5,000 U.S. residents older than age 65 in 2005, and of 145 medical schools nationwide, only nine have geriatric departments.
In addition, "teaching hospitals graduate internists with as little as six hours of geriatric training," the Times reports.
Geriatrics is a specialty "about managing, not curing, a collection of chronic conditions"; "balancing the risks and benefits of multiple medications"; and trying "nonmedical solutions," according to the Times.
Such "common-sense remedies" exist in a health system that "rewards the heroics of specialists in both compensation and prestige," the Times reports, noting that the "best paid doctors are those who do the most procedures."
Radiologists and orthopedic surgeons, for instance, have average annual incomes of $400,000, compared with $150,000 for geriatricians.
One possible solution to the shortage is for geriatricians to limit their practice to the most delicate elderly patients, those older than 85 and those 65 to 85 who have complicated conditions.
"Another solution, gaining a foothold among the nation's top academic geriatricians" is to teach the primary principles of the specialty to all doctors "because it is unrealistic to assume there will be enough geriatricians to go around," the Times reports.
Leo Cooney, a professor at Yale University School of Medicine, said, "If we got to the point where everybody in the health care system was an expert in caring for older people, we wouldn't need geriatricians.
Or we wouldn't need them as frontline providers. We'd be like consultants, making sure everyone else was as skilled as possible" (Gross, New York Times, 10/18).