The population of the United States is aging rapidly, with most Baby Boomers now in their 50s and 60s. According to the Senior Market Advisor, in 20 years we’re going to need 36,000 geriatricians, vastly more than the approximately 7,000 we have now. And the number of new medical school graduates who are heading into the field of geriatrics is falling, due in large part to the fact that geriatrics just doesn’t pay as well as most other specialties. That makes sense, as medical care for nearly all seniors in the US is paid by Medicare. And for those who need long term care in a nursing home, 68% are on Medicaid. Specialties that are primarily reimbursed by private health insurance tend to be much more lucrative than those that are mostly reimbursed by Medicare and Medicaid. In addition to the financial aspect, geriatrics is a difficult profession, requiring a special kind of person who can work with end of life issues, dementia, and patients who just don’t heal as well as their younger counterparts.
It’s understandable why geriatrics isn’t the most sought-after specialty among medical students, and it would seem like a perfect scenario for a bit of financial incentive from Uncle Sam. But Chris Langston at Health AGEnda explains how the health care reform legislation is actually going to provide much more financial incentives (in the form of loan repayment programs) to doctors who choose pediatrics than to those who choose geriatrics.
By 2030, 20% of Americans will be 65 or older. That’s a huge increase from 2008, when just under 13% of the population was 65 or older (interestingly enough, people in Colorado are a little younger than average, with just over 10% of our population in the senior category). There’s a pretty obvious need for a dramatic increase in the number of medical students entering the field of geriatrics, and it is a bit perplexing as to why the health care reform legislation didn’t put more emphasis on loan repayments and other financial incentives to encourage doctors to pursue a career in geriatrics. My guess is that as the shortage of geriatricians becomes more pressing over the next few years, we might see some additional funding aimed at solving the problem.
The Health AGEnda article was included in Grand Rounds this week.