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Nation needs to attract more doctors, caregivers as baby boomers begin to turn 65, institute says
By Aliza Marcus
Bloomberg News
Published on Tuesday, Apr 15, 2008
The United States needs an ''immediate and dramatic'' increase in the number of medical workers specializing in the elderly to prepare for the influx of baby boomers who begin turning 65 in three years, a study found.
The nation is projected to need about 36,000 doctors certified in geriatrics by 2030, according to a report released Monday by the Institute of Medicine, part of the government-chartered National Academy of Sciences. There were 7,128 such doctors practicing as of last year, and on the basis of current trends, the institute is expecting less than 10 percent growth by the target daten.
Federal and local governments and private organizations should offer financial incentives and training opportunities to attract people to geriatric care, the study recommended. The elderly population is expected to almost double to 70 million by 2030, the year that the last of the boomers — the generation born from 1946 to 1964 — will reach age 65.
''We're going to need more and better,'' said David Reuben, a member of the committee that produced the report and a geriatrician-researcher at the University of California at Los Angeles. ''Not just of providers. We also need better training of existing
health professionals and direct caregivers.''
Skills will need to be adjusted for the changing needs of the next generation of senior citizens, according to the report. While fewer older Americans may be smokers, more of them may require care for the effects of obesity.
''There is the idea that if we can fix and sustain the Medicaid and Medicare system in this country, we're going to be OK, but that is only half the problem,'' said John Rowe, chairman of the Committee on the Future Health Care Workforce for Older Americans. ''The other half is the lack of a geriatric health-care work force. Even if there is enough money in the health-care system, there is no one there to provide care.''
Rowe said the number of geriatric specialists is decreasing because many are reaching retirement age, and because they are not paid as much as other specialists. According to the study, the average salary for a geriatrician in 2005 was $163,000, compared with $175,000 for a general internal medicine physician and $207,000 for a rheumatologist.
The study shows that ''patients around the country are beginning to feel the effects of physician and nursing shortages,'' said Dr. Cecil Wilson, an American Medical Association board member.
Part of the problem is that geriatric and long-term care tend to be financed by public programs such as Medicaid and Medicare, which pay less than private insurance, said Carol Raphael, another Health Care Workforce committee member.
''Medicare and Medicaid make up 15 (percent) to 25 percent of some states' budgets, so the amount available waxes and wanes, depending on the economic circumstances,'' Raphael said.
Physicians who specialize in the elderly are not the only health professionals at the low end of the wage scale.
''In-home nursing is also a low-wage occupation,'' said committee member Susan Chapman. ''Nurses are paid $10 to $15 an hour for an emotionally and physically straining job. We need to make these long-term, sustainable jobs and cut down on the turnover.''
The report urged that all health workers be trained in basic geriatric care and that schools increase training in the treatment of older patients.
The federally required minimum number of hours of training for direct-care workers should be raised from 75 to at least 120, the report said, noting that more training is required for dog groomers and manicurists than direct-care workers in many parts of the country.
The report also urged training for family members and other informal caregivers who assist the elderly.
AARP, the organization for older Americans, said the report highlights the growing need for immediate action to improve and strengthen the medical work force.
''We know the problem, and we know how to begin to fix it,'' said AARP President-Elect Jennie Chin Hansen.
The group said it is endorsing a bill by Sens. Barbara Boxer, D-Calif., and Susan Collins, R-Maine, intended to steer caregivers toward geriatric and long-term roles, and create an advisory panel to make recommendations.
The Associated Press and Cox News Service contributed to this report.
The United States needs an ''immediate and dramatic'' increase in the number of medical workers specializing in the elderly to prepare for the influx of baby boomers who begin turning 65 in three years, a study found.
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