"Bill of Health"-Generating Geriatricians
Thursday, February 22, 2007SUSIE PRATT: The nation's senior population will grow to 70 million people over the next two decades. Yet, at present rates of retirement, the number of doctors who treat elderly patients, geriatricians, will drop to just half of today's numbers. As Jeff Yastine reports in his latest Bill of Health, it's a trend physicians are struggling to turn around.
JEFF YASTINE, NIGHTLY BUSINESS REPORT CORRESPONDENT: Everyday, Dr. Gloria Weinberg sees her patients, people in their 70s, 80s and older, who look to her for guidance on their health and medications. Its a role she enjoys, but Dr. Weinberg says there's more to the job than diagnosing individual conditions.
DR. GLORIA WEINBERG, DIR. MEDICAL TRAINING PROGRAM, MT. SINAI MEDICAL CTR.: As people age, they tend to accumulate medical problems. So you really need to be adept at sorting out, prioritizing and looking at all of the issues and all the medications that are being prescribed, all of the interactions. You need to pay attention to problems like gait, memory, depression, etcetera.
YASTINE: According to medical groups, the number of geriatricians is shrinking, as the need for such physicians continues to grow. There were more than 9,000 practicing geriatricians in 1998. Today, there are fewer than 7,000. By some estimates, the nation needs 14,000 now and 36,000 geriatricians by 2030 to care for a population of seniors that will have nearly doubled.
So what's the problem? Experts say pay levels for geriatricians are less compared to other specialties. It takes longer to see geriatric patients, which also limits physician incomes. Reimbursement rates from Medicare are also low and subject to change. Medical schools have begun to adjust their curriculums to give young doctors exposure to the particulars of geriatric care. But others see the primary role of geriatricians as an overall coordinator of an aging person's healthcare.
DR. LEO COONEY, PROF. OF GERIATRIC MEDICINE, YALE UNIV. SCHOOL OF MEDICINE: My belief is that older people, those over 80, are still best cared for by good general physicians, internists and general practitioners. The role of the geriatrician is to assist the general physician in caring for the older person and to help institutions and systems deal as well as they can with older people.
YASTINE: That means advising surgeons and other specialists when a patient has major problems. And in an era when more and more physicians specialize in one kind of medicine, a geriatrician must be expert in a wide-range of medical applications.
WEINBERG: When you're a geriatrician, it probably is the only medical subspecialty where you're actually expanding your knowledge base. So at a time when medical knowledge is increasing by leaps and bounds, you are not coning down and decreasing what you're responsible for. The reality is that you're increasing it.
YASTINE: Geriatricians say that should be a welcome challenge for young doctors, who will be needed to fill their ranks in the decades ahead. Jeff Yastine, NIGHTLY BUSINESS REPORT, Bill of Health.
