NCPA - National Center for Policy Analysis


October 18, 2006

Even as the population ages and more people need them, geriatricians are in short supply. It is a specialty of little interest to medical students because geriatricians are paid relatively poorly and are not considered superstars in an era of high-tech medicine. In fact, the credo of geriatric medicine is "less is more."

  • In 2005, there was one geriatrician for every 5,000 Americans 65 and older, a ratio that experts say is sure to worsen.
  • Of 145 medical schools in the United States, only 9 have departments of geriatrics.
  • Few schools require geriatric courses and teaching hospitals graduate internists with as little as six hours of geriatric training.

The mismatch between supply and demand is "a troubling issue for us," said Dr. Leo M. Cooney, a professor at Yale University School of Medicine.  In a good year, Dr. Cooney said, one of 45 internal medicine residents decides to be a geriatrician.

The rest, he said, choose "super specialties" like cardiology or oncology.  This, despite the fact that geriatricians reported the highest job satisfaction of any specialty in a 2002 survey in the journal Archives of Internal Medicine.

  • One proposed solution to the shortage is for geriatricians to limit their practice to the frailest of the elderly, generally those past 85, along with a subset in the 65-to-85 age bracket who have complicated needs.
  • According to a 2002 study at Johns Hopkins University, 20 percent of those 65 and older have at least five chronic conditions.
  • Another solution, gaining a foothold among the nation's top academic geriatricians, is to focus on teaching the core principles of their specialty to everyone, be they surgeons or discharge planners, because it is unrealistic to assume there will be enough geriatricians to go around.

Source: Jane Gross, "Geriatrics Lags in Age of High-Tech Medicine," New York Times, October 18, 2006.

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