Looking for a geriatrician? Good luck. There are only a few of these specialists trained in the science of aging, which presents a problem for a country that is quickly growing older.
Caring for older adults will reach a critical point as the number of medical specialists that are trained for this age group is growing slower than the population, according to the Association of American Medical Colleges.
“Specialized knowledge about how biology and physiology change with age is critical. For example, medications can be metabolized and absorbed differently as we grow older. A medication we have been on for years can suddenly work differently,” said Tracey Gendron, chair of the department of gerontology and executive director of the Virginia Center on Aging at Virginia Commonwealth University. “Polypharmacy can also be a concern, as can prescribing medications that are contraindicated for older adults.”
There are currently 6,100 active geriatricians – specialists trained in the care of older adults – out of 950,000 active physicians in the country, according to the Association of American Medical Colleges. That’s only 0.64% of the physicians nationwide.
The country will need about 12,320 geriatricians by 2030, the American Geriatrics Society said. About 30% of people aged 65 and older need the specialized care of a geriatrician, AGS said.
There are more than 55.8 million adults ages 65 and older living in the U.S., accounting for about 16.8% of the nation’s population, according to the Census Bureau. That number is quickly changing as 10,000 people a day turn 65.
Globally, there are 703 million people aged 65 or older, a number that is projected to reach 1.5 billion by 2050, according to the United Nations’ department of economic and social affairs. That means one in six people in the world will be over the age 65 by 2050, up from 1 in 11 in 2019, the UN projects.
“The specialty has been growing slowly over the past 15 to 20 years, but relative to the need, it has not been growing fast enough for the population,” said according to Michael Dill, director of workforce studies for the Association of American Medical Colleges. “Many of these specialists also will be retiring soon. More and more will be retiring at about the same time we see more and more patient-population need.”
What’s needed to turn the tide?
“Specialty training should be the standard,” said Gendron. Such specialization could be accomplished in a few different ways, like having specific geriatrics curriculum and rotations in medical school.
Why is there a lack of geriatricians?
Gendron points to several factors, including ageism.
“I do believe that ageism plays a role in the lack of interest in geriatrics,” Gendron said. “Negative attitudes about aging, therapeutic nihilism, and low reimbursement rates are all contributing factors to a lack of interest.”
Gendron said ageism also influences our assumptions about aging and older people, which can result in misdiagnosis and undertreatment. For example, if a physician believes that pain is a normal part of aging or depression should be expected, then these can go undetected and under-treated, she said.
A 2018 study by the Yale School of Public Health, published in “The Gerontologist,” found that ageism against those 60 and older cost $63 billion a year – or $1 of every $7 spent on the eight most expensive health conditions.
Also, ageism resulted in 17.04 million cases of these health conditions as prejudices or stereotypes led to issues such as greater cardiovascular stress, causing serious events such as stroke or heart attack, the study found.
“The findings suggest that a reduction of ageism would not only have a monetary benefit for society, but also have a health benefit for older persons,” the study said.
“We are absolutely going to – and already have – a critical shortage of appropriately trained professionals equipped to best serve older people,” Gendron said.