Geriatrics is one of the few medical specialties in the United States where the labor pool is shrinking even as the need is expanding. While its ranking is currently at the bottom of the list of specialties that internal medicine residents choose to pursue, this signals an opportunity for those looking for a field in which job openings abound. If you are thinking about changing careers, this may be an arena to consider.
The US is Growing Older, On Average
As life expectancy doubled during the 20th century, more people are living longer and working harder to stay independent. As a result the global geriatric care services market is expected to reach over a billion by 2022.
According to data published by the United Nations in 2014, it is estimated that by the year 2022, approximately 35% of the population would be above 60 years of age. This means a boom for the growth of the geriatric care services market.
Shortage of Geriatric Doctors
Currently in Oregon there is approximately one geriatrician for every 3,000 people over 75. The shortage will grow more acute as the state’s population continues to age. That problem is reflected across the United States. There are about 7,000 geriatricians in practice today in the United States. The American Geriatrics Society estimates that to meet the demand, medical schools would have to train at least 6,250 additional geriatricians between now and 2030, or about 450 more a year than the current rate.
However, trends show that the geriatric field is becoming even less popular among physicians in training. Oregon Health and Science University had five slots open for geriatrics fellows for 2016 and filled only three.
A geriatrician is a physician already certified in internal or family medicine who has completed additional training in the care of older adults. In addition to providing clinical care, geriatricians are skilled in navigating the labyrinth of psychological and social problems that often arise in the aging population.
Geriatrics doesn’t pay as well as some fields, but better than others
According to a NY Times article, people avoid the field for understandable reasons. Geriatrics is among the lowest-paying specialties in medicine. In 2014, the median yearly salary of a geriatrician in private practice was $220,000, less than half a cardiologist’s income. Although geriatrics requires an extra year or two of training beyond that of a general internist, the salary for geriatricians is nearly $20,000 less. Additionally, as the cost health care of older patients is often covered by Medicare, the federal insurance program’s low reimbursement rates make sustaining a geriatric practice difficult, many in the field say.
While some primary care physicians argue that geriatricians are unnecessary, that the ailments among older adults are the same as those that hit the middle-aged population, such as diabetes, hypertension and heart disease. But geriatric doctors disagree, stating that the specialization allows them to focus on getting their patients functional, while managing older age diseases like dementia and Alzheimer’s.
While many in geriatrics have resigned themselves to the shortage, other feel the field will soon receive the recognition it deserves. New payment models that hold doctors and health systems accountable for keeping people healthy are on the rise, and geriatricians foresee a day when they are better valued and compensated. This is substantiated by pushed for pay for performance measures being discussed by insurance companies.
More the doctors needed to meet the growing demand
In addition to the need for doctors, there is an emerging emphasis on training many different health care professionals — nurses, pharmacists, internal and family medicine physicians, physician assistants, and physical and occupational therapists — to see older patients through a geriatrics lens rather than focusing solely on creating more geriatricians.
Mini-fellowships at teaching hospitals to train practicing physicians in geriatrics have sprung up around the country. Cardiology, urology, emergency medicine and other specialties are promoting geriatrics training and research within those disciplines.