Opinion: How a geriatric-based approach could improve health care
Pamela Paul, a culture and politics columnist, detailed the causes and implications of the decline in geriatric care.
In an opinion piece published in The New York Times, Ms. Paul explained that as individuals age, they may experience poorer immune system functioning, declines in muscle mass and changes in organ performance — necessitating specialized geriatric care. However, medical school students often aren’t educated about or exposed to the patient-centered treatment approaches older patients may require.
Ms. Paul stressed that the growing size of the U.S. population over 65 years of age has led to an insufficient number of clinicians in geriatric care. For every 10,000 older patients, there is just one geriatrician to provide care. Additionally, the field of board-certified geriatricians has shrunk from 10,000 in 2000 to less than 7,500 in 2022, representing the increasingly limited accessibility of specialized geriatric care.
Geriatricians often focus their care on medication, mental activity, mobility and multicomplexity — allowing them to treat multiple chronic conditions, manage treatment noncompliance as well as prioritize several competing medical needs on the basis of the patient’s decision-making. This type of care can be more complex and come with lower reimbursement rates compared with other medical specialties, a perception that has led to a shift away from geriatrics. For instance, geriatric fellowships in 2022 demonstrated the lowest match rate across 71 medical specialties.
Despite the common opinion of geriatric care, geriatricians have encouraged more clinicians to join the practice. They argued that the field boasts a large proportion of geriatricians who report feeling happy with their occupation, partly as a result of the patient-based care they provide. Many geriatricians describe their work with words such as “commitment” and “passion.” Ms. Paul highlighted that geriatricians are given the opportunity to listen to their patients’ stories and understand them on a more personal level. She concluded that even though the field continues to decline, other parts of the health care system have begun to implement solutions based on geriatric principles.
Read more: The New York Times
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