ARTICLE TOOLS
Text Size: A
A
A
A
Chattanooga: Elderly care needs rise
 | |
|
| |
| Dr. John Standridge | |
Dr. Lorna Birch listened with growing awe as the 85-year-old woman in her office ticked off the names of all the doctors treating her — eight total, from a gynecologist and gastroenterologist to an oncologist and general surgeon.
“She could not keep up with all her appointments,” recalled Dr. Birch, a local geriatrician. “But (her health) was still declining because they were dealing with fragments of her health. They weren’t looking at the whole picture.”
As a geriatrician — a primary care doctor who specializes in the care of the elderly — Dr. Birch said she pays special attention to the challenges of treating multiple chronic conditions and coordinating care from a number of specialists.
“We’re kind of like the gatekeepers,” she said.
America’s aging population will intensify the need for these gatekeepers in the future, experts agree. However, the number of doctors trained to address the complex health needs of the elderly is “woefully inadequate,” according to an April study by the Institute of Medicine, a nonprofit created to provide expertise on matters of biomedical science, medicine and health.
From 2005 to 2030 the number of people 65 and older nearly will double, from 37 million to more than 70 million, according to the Institute of Medicine.
“We do not have the infrastructures, the facilities or the physicians that are specialized in geriatric medicine to really handle that influx of patients that are going to be coming into this (elderly) population,” said Dr. Scott Evans, the first graduate from the University of Tennessee College of Medicine in Chattanooga’s geriatric fellowship training program, which launched in 2005. He now works at the East Cooper Family Practice in Mount Pleasant, S.C.
Board-certified geriatricians — physicians in family medicine or internal medicine who complete additional training to become certified in geriatrics — total about 7,590 in the United States, according to the Association of Directors of Geriatric Academic Programs.
That’s a ratio of one geriatrician for every 2,500 Americans 75 or older. The ratio will drop sharply by 2030, as the elderly population balloons, to about one for every 4,254 older Americans, the association said.
By 2030 the U.S. population will need about 36,000 geriatricians, according to the Alliance for Aging Research, a nonprofit advocacy group promoting research into aging.
Yet the current health care system is set up to deter interest in geriatrics, a Chattanooga doctor said.
Geriatrics, which has one of the lowest percents of graduates of U.S. medical schools in its fellowship training programs, also has one of the lowest salaries compared to other specialties, according to the Association of Directors of Geriatric Academic Programs.
“This is one of the few areas where you can offer somebody an additional year of study in a fellowship program and guarantee them less money than ... if they hadn’t done that,” said Dr. John Standridge, director of the geriatric medicine fellowship program at the UT College of Medicine in Chattanooga. Dr. Standridge is writing an article titled “Geriatrician Attrition” to bring attention to the issue.
“These are our most frail and vulnerable populations. They need people who care about them and care for them with expertise,” Dr. Standridge said.
Staff Photo by Angela Lewis
Dr. Lorna Birch walks with Wendell Smith at the Alexian Brothers PACE Center clinic.
Medical groups, as well as the AARP, are advocating more incentives to attract and keep doctors in geriatrics.
Patrick Willard, director of advocacy for the state AARP, said the group supports the Caring for an Aging America Act, introduced in Congress in March by U.S. Sen. Barbara Boxer, D-Calif. The proposal would give $130 million in federal funding over five years to draw medical students and direct-care workers into the field through loan forgiveness programs and career advancement opportunities.
“Obviously this is an issue that’s going to have increasing importance in the future,” Mr. Willard said.
DECLINING NUMBERS
The number of U.S. medical school graduates entering geriatric medicine fellowship programs decreased from 167 in 2003 to 91 in 2007, according to the Association of Directors of Geriatric Academic Programs.
Even including international students, who make up the majority of geriatric fellows in U.S. programs, only 54 percent of first-year geriatric fellowship positions were filled in the 2006-07 school year, the association said.
Additionally the number of medical students choosing family medicine and internal medicine residencies — the specialties from which geriatric fellows are drawn — is dwindling, said Viston Taylor, president and CEO of Alexian Brothers Community Services.
“We’ve gotta change the way we pay doctors in this country if we’re ever going to see those numbers get better,” he said. “If it weren’t for foreign-educated medical graduates coming into those positions, we wouldn’t have enough today.”
Sally Brewer, area program director for the Alzheimer’s Association’s regional office in Chattanooga, said all health care professionals need some training in treating the elderly and those with Alzheimer’s or other dementias.
The group recently held a number of forums across the state to assess the needs of people with Alzheimer’s and their caregivers. A recurring theme was the lack of training for doctors, caregivers and health care facility staff members in recognizing and dealing with dementia and aging-related illnesses.
“You still have physicians in town that will play off dementia in the early years, when you could be doing things about it prevention-wise or keeping an eye on it,” she said.
About 10 million baby boomers in the United States — about one in eight — are expected to develop Alzheimer’s disease, according to the Alzheimer’s Association.
Above all, a geriatrician’s mindset is focused on a team-based approach to improving quality of life, rather than emphasizing overly aggressive treatment for ailments, Dr. Birch said.
“I’ve realized in geriatrics that I’m not gonna cure anything, for the most part,” she said. “But if I can keep a patient as functional as possible, then I’ve accomplished what I wanted to do.”
- Kennedy: Affording college tomorrow
- Preparing for frat reunion takes tongue wagging
- Retirement means new emphasis on thrift
- Flustered Fred leads the charge to birth of grandbaby
- Real Estate Briefs
- Trees are hallmark of Kensington Park: Cleveland subdivision features oaks at entrance, maples in yards
- Business Digests
- Chattanooga: Business grapples with gas shortage
- Parkinson’s most often progresses slowly
- Leg clots can travel to the lung
- Ulcerative colitis strikes youngsters as well as adults
- Restaurant Inspection Report
This document may not be reprinted without the express written permission of Chattanooga Publishing Company, Inc.
Comments
Post a comment
Commenting requires registration.