Medicine, and Medicare, must prepare for more elderly patients

Medical schools, practicing physicians and the federal government all have roles to play in seeing that there are enough doctors trained in geriatric care.

Editorial. March 17, 2003.

Alzheimer's disease. Dementia. Diabetes. Arthritis. High blood pressure. Hearing loss. There's a substantial likelihood that most Americans will face one or more of these medical conditions as they age.

Unfortunately, there's also a likelihood that it will be increasingly difficult for aging patients to find a physician who specializes in treating them and their medical needs.

According to the Centers for Disease Control and Prevention, the number of Americans 65 and older will increase from 35 million to 71 million between 2000 and 2030. Senior citizens will make up 20% of the population -- up 8% from the roughly 12% they account for now.

By that time, the Alliance for Aging Research, based in Washington, D.C., estimates that the country will need 36,000 geriatricians.

Yet, the number of physicians who specialize in the problems and diseases of old age is expected to drop precipitously in the next year alone. There are about 9,000 geriatricians now practicing, but the Alliance estimates that number will drop to 6,100 by 2004 as physicians give up practice in the face of low Medicare reimbursements or retire. Few experts are predicting the hemorrhaging can be slowed, let alone reversed. Generalist physicians will be expected to pick up the slack.

Just recently, the CDC highlighted the seriousness of the problem by calling on public health officials to expand their mission to include promoting health in older adults, preventing diabetes -- a major health concern for the aging -- and maintaining quality of life.