June 27, 2013, 2:35 PM
By Matthew Heimer
With the American population gradually skewing older as the boomer generation reaches retirement age, demand for geriatricians – doctors who specialize in treating older people – has never been higher. The American Geriatrics Society estimates that the country will need about 25,000 geriatricians by the year 2025. So it’s distressing to see that, if anything, doctors appear to be fleeing the specialty: In a post on The New Old Age blog at The New York Times this week, Judith Graham reports that there are currently only about 7,200 certified geriatricians, down 18% from the profession’s peak in 1996.
There are many factors at play in this trend, including a broader shortage of doctors nationwide. But as Graham notes, geriatricians are also being stung by a medical-insurance model that reimburses doctors based on face-to-face visits, tests and treatments – but not for the kind of broader wellness evaluations and coordination of complex care that older patients often need. Primary-care doctors (another specialty whose ranks face significant shortages) have been raising similar complaints in recent years. And while the reimbursement issue is a problem that’s usually associated with private insurance companies, Graham notes that Medicare has similar rules and incentives, forcing many geriatricians to squeeze more patients into shorter sessions so they can earn enough to pay their bills.