Preparing Physicians to Care for Growing Older Adult Populations

By Richard Shank

The demand for geriatric care is continuing to spike and is running up against an alarming shortage of health care providers with expertise in geriatric care. Earlier in 2009, the American Geriatrics Society, the American Medical Association, and the Council of Medical Specialty Societies held a joint meeting to address the growing need for geriatric training in all areas of medicine. The meeting resulted in a position paper, available at www.americangeriatrics.org/education/white_paper.pdf, that suggests medical specialty training include geriatric competencies in residency programs.

Older adults are more likely to have multiple chronic conditions than the general population, and the care management involved requires specialized knowledge and forms of care. It’s estimated that in the U.S., currently there are 12,000 too few geriatricians, and this number is expected to grow to 28,000 in the next 20 years. Only a handful of privately funded, long-standing geriatric training initiatives exist, including the American Geriatrics Society’s Geriatrics-For-Specialists Initiative.

The challenge going forward will be how to reach the goal of training new physicians in the 26 geriatric competencies (outlined by the Association of American Medical Colleges), which focus on eight domains of expertise: medication management; cognitive and behavioral disorders; self-care; falls, balance, and gait disorders; health care planning and promotion; atypical diseases; palliative care; and hospital care.

Getting beyond the “white paper” phase has been difficult, as few medical specialties approach comprehensively training their professional members in all 26 competencies. Furthermore, it appears that tools for evaluating the training quality have yet to be developed and validated for use in medical education.

Source: Kuehn, B. 2009. Effort under way to prepare physicians to care for growing elderly population. JAMA 302(7): 727-728.

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