Wills, Trusts & Estates Prof Blog

Editor: Gerry W. Beyer
Texas Tech Univ. School of Law

Sunday, January 5, 2020

Older People Need Geriatricians. Where Will They Come From?

GeriatricsAs the population of the country ages, the need for geriatricians - doctors that specialize in caring for the elderly - also increases. Geriatrics became a board-certified medical specialty only in 1988, and though the demand for this type of physician is getting higher, the supply of them unfortunately is not. The number of fellowships that train geriatricians has not increased by much and therefore is virtually stagnant.

A federal model estimates that one geriatrician can care for 700 patients with complicated medical needs. Following this guideline, the country will need 33,200 of these doctors by the year 2025, and currently America has 7,000 - half of which do not practice full time.  It is estimated that 30% of Americans over the age of 65 needs a geriatrician, especially those that suffer from 3 or more chronic conditions and have reached the age of 85. Geriatricians earn on average $233,564 a year, much less than what anesthesiologists, radiologists, and cardiologists are compensated. This may be due to Medicare paying less than traditional insurances and often slower pay outs.

A miraculous influx of doctors specializing in geriatrics is highly unlikely, and thus geriatricians are taking an alternative approach. Dr. Mary Tinetti, chief of geriatrics at the Yale School of Medicine, says that the "most important thing geriatricians can do is make sure all their other colleagues” understand these patients’ needs, she said, including nurse-practitioners, physician assistants, therapists and pharmacists. Currently cardiologists and oncologists often focus on older patients. The Senate Committee on Health, Education, Labor and Pensions voted to reauthorize a $41 million program that educates health professionals in geriatrics just last month and is awaiting a floor vote.

See Paula Span, Older People Need Geriatricians. Where Will They Come From?, New York Times, January 3, 2020.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.


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Of course I wrote a long comment and then it disappeared from view :( My point was that geriatrics is not the only specialty that addresses the medical concerns of an aging population. Many Forensic Psychiatrists, Psychologists, Neuropsychologists and Neurologists are trained and experienced specifically in matters that are the result of the vulnerabilities, medications and medical conditions that can contribute to undue influence and elder abuse. Further, dementia and Alzheimer's interfer with competency and testamentary capacity and in the arena of personality andmental health, a geriatrician is perhaps not as useful an evaluator or, perhaps expert witness, than a psychiatrist with unique experience in the area of assessment, opinions and testimony about whether a person is vulnerable to undue influence or unable to exercise Free Will.

Posted by: Beryl Vaughan | Jan 7, 2020 5:32:09 PM

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