Preparing for an older patient population

Quick View. May 1, 2006.

A new work-force study underscores the need for more physicians to treat the growing number of older Americans, particularly the need for geriatricians.

The older adult population will:
Surge
(% of total population)			2000	2020
65 and older			34.4 million (12.5%)	82.0 million (20.0%)
85 and older			4.0 million (2.0%)	6.7 million (5%)

Ethnically diversify
65 and older			2000	2020
White			83%	77%
Black			8%	8%
Hispanic			6%	9%
Asian			3%	4%

Be more educated
65 and older	1950		2000
Completed high school	18%		66%
Graduated college	4%		15%

Be wealthier
65 and older	1966	1975	1998
400% or more of poverty		17.4%	27.5%
in poverty	28.5%	13.3%	10.5%

Continuing medical education in geriatrics could be invaluable for the average internist or family physician, and expanding what medical students and residents learn about geriatrics would be helpful, study authors say. The report also offers a glimpse at what the graying of the United States will look like to primary care physicians and what the demographic shift might mean for doctors. These are some highlights.

All this means physicians need to be prepared to:

Treat older patients who want to be more active participants in their care. They will show up with an Internet printout in hand, asking for specific medications or procedures.
Possess cultural competency skills to treat a more ethnically diverse group. Speaking Spanish will be useful as the number of older Hispanics grows. Also, population models anticipate older blacks will continue to have higher mortality rates than nonblack peers, suggesting more work is needed to address disparities in care.
See a larger percentage of older adults among their patient base. These patients will be likely to have at least one chronic condition, if not more, that requires more complex care and more frequent visits.
Possibly embrace different models of care. Some doctors advocate interdisciplinary practices, where a diabetic patient could see his or her physician, podiatrist and nutritionist in the same office.
Possibly use telemedicine. Older adults are more likely to live in rural areas, and those that do are more likely to be poor. These older rural dwellers might be reluctant to drive long distances, even for health care. Telemedicine could be a solution, but it's unclear if proper reimbursement will be there to establish a service.

Source: Center for Health Workforce Studies, University of Albany, New York

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The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment.
Meeting coverage - Slideshow