With all the advances in health care and medicine over the past few decades, it is no wonder that Americans are living longer, healthier, and happier lives. Extended lifetimes also mean that older patients will need special attention to their medical needs, and as a recent article in Newswire noted, “changes in medical education policy.”
These changes in medical education are necessary “at multiple levels to ensure that physicians are ready to treat the country’s growing older adult population.” As a result, Chad Boult, MD, MPH, MBA, director of the Roger C. Lipitz Center for Integrated Health Care at the Johns Hopkins Bloomberg School of Public Health, and co-authors Steven R. Counsell, MD, Rosanne M. Leipzig, MD, PhD, and Robert A. Berenson, MD, proposed in the May issue of Health Affairs several policy solutions to help the United States prepare for the coming influx of geriatric patients.
America is in need of these recommendations because there is only “one geriatrician for every 10,000 adults over 75.” This forces many primary care physicians to provide geriatric care for a rapidly aging population,” which presents a problem. According to Dr. Boult, “most of today’s primary care physicians are not adequately trained to provide the complex care needed by older adults with multiple chronic conditions.” With 70 million people aging over 65 in the next twenty years (1 of 5 Americans), Dr. Boult asserted that “we need to act now, and act aggressively, to improve the geriatric education of all physicians.”
In their article, entitled “The Urgency of Preparing Primary Care Physicians to Care for Older People with Chronic Illnesses,” the authors propose multiple policy-driven solutions to ensure a better trained physician workforce. Recommendations include:
– Increasing funding for geriatrics in medical schools;
– Leveraging Medicare’s educational subsidy to strengthen geriatrics in residency and fellowship programs;
– Requiring practicing physicians to complete geriatric continuing education credits in order to maintain their state licensures and Medicaid provider certifications;
– Modifying Title VII of the U.S. Public Health Service Act to provide financial support for medical schools and residency programs that adopt the educational innovations needed to care for an aging society;
– Making Medicare continued educational funding contingent on rapid reforms in the training of resident physicians and specialty fellows; and
– Linking a significant portion of teaching hospitals’ annual direct and indirect medical education payments to the amount of training they provide in primary care, chronic care, and geriatrics;
– Extending Medicare graduate medical education funding to non-hospital clinical training sites, such as nursing homes; and
– Changing state polices to require geriatric continuing education credits for physicians to maintain their licensure, or to practice as Medicaid providers or medical directors of nursing homes.
Ultimately, since the health care demands of a growing elderly population will rapidly change the way our health care system operates, physicians need continuous geriatrics training to be ready to address these needs. As a result, enacting educational policy reforms at the state and federal levels will help “bring workforce changes necessary for delivery of cost-effective chronic care to the rapidly swelling ranks of older Americans.”