MSU to establish statewide Division of Geriatric Medicine

New division to establish network of fellowships

An unprecedented decade of economic demise and a population older than 80 percent of all other U.S. states is putting Michigan in a precarious spot: More aging residents needing health care with fewer resources to pay for it.

Add in a steady decline in elderly support ratio - the number of working age adults per older adult - and the situation becomes more dire. But with the help of an $800,000 federal grant, Michigan State University's College of Osteopathic Medicine is taking steps to address the needs of older adults and at the same time lower health care costs.

With funding from the U.S. Health Resources and Services Administration, the college will establish a statewide Division of Geriatric Medicine, creating a network of osteopathic geriatric fellowships in Michigan. The fellowships will allow doctors to undergo specialized training after their residencies.

The goal is to build a multidisciplinary model of care via community-based education, training and research with the use of distance learning, said Carol Monson of the Department of Family and Community Medicine.

"Given our aging population and the trend of more elderly people moving back to Michigan to be closer to family members for their health care needs, it will be the family physicians, general internists, physician assistants and nurse practitioners who will be the sources of primary medical care for these older adults," Monson said. "Those providers need the consultation of fellowship-trained geriatricians, yet there is a significant shortage in that field."

She said the diversity and limited resources of Michigan's aging population require effective training be community-based, culturally relevant and multidisciplinary. MSU's new Division of Geriatric Medicine will tackle those issues on several fronts:

• Work with residencies affiliated with the College of Osteopathic Medicine to establish a network of osteopathic geriatric fellowships in Michigan.
• Develop a series of geriatric educational modules (including those delivered via distance learning) available to all fellowships and residency training programs to enable training in geriatrics through the entire post-doctoral curriculum.
• Create a geriatric medicine curriculum to be required for all medical students during the first two years at the college's three campuses.

"At each of these levels, we see the opportunity for interactional learning and development between medical students, clerkship students, residents, geriatric fellows and faculty with each other and professionals from other disciplines," Monson said, in hopes of achieving "optimal aging."

Monson said the focus on geriatric medicine also is crucial to reigning in health care costs.

"We can provide better care and lower costs by getting a good assessment of what services are needed by the patient and exploring the possibility that these needs can be met by other support systems already in place," she said. "We need geriatricians to do this type of assessment.

"Also, the preventive aspect of treating patients in group settings with interdisciplinary personnel may decrease the need for more expensive visits to physicians' specialists."

Additionally, most money is spent on care to the elderly during the final of life, when they often have very poor quality of life.

"Early intervention can decrease the need for costly in-patient services for a patient who knows they are terminal and is willing to be treated in a hospice care situation rather than a hospital where they often receive less personal but costlier care."