Geriatrics is a Wide-Open Career, Expert Tells Students

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  The rapid rise of elderly Americans as the baby boom generation matures is leading to an unprecedented number of opportunities in geriatric medicine, the deputy director of the National Institute of Aging (NIA) told 200 students and faculty recently at the University of Maryland, Baltimore.

"NIA is doing a lot of innovative and interesting research and there are many opportunities for young people," said Marie Bernard, MD, who spoke to at the request of the School of Medicine’s Center for Research on Aging. She added, "I am concerned that young people are hearing about flat-line budgets and they should not be discouraged."

Center co-founder Jay Magaziner, PhD, MSHyg, said, "With the aging of the post-World War II baby boom generation, a fifth of the U.S. population will be over age 65 within the next 20 years. Given the special care needs of this group, Dr. Bernard pointed out the need to prepare a health care work force that can meet the growing demands for their care."

Bernard said, "We don’t have enough providers, such as nurses, doctors and pharmacists in geriatrics for the coming growth of our field." She said because older people are increasing in numbers, they use more services, and current care is not optimal.

Better health care and nutrition in some parts of the world have led to a worldwide increase in the number of people 65 and older, while the number of people ages 5 and younger is decreasing, she said. "This is a global issue," said Bernard.

She also noted specific health problems as U.S. residents age. In the United States, females are not living as long as women in other industrial countries. Obesity for U.S. citizens is the highest among industrial countries, she said. In 1990, all U.S. states reported less than 20 percent of their population as obese. Now most of the states report more than 20 percent of their population as obese. She added that the percentage of the population developing diabetes is also rising, even in younger age groups.

She said that about 80 percent of American elderly people have a chronic disease. They also have unique geriatric syndromes. The 12 percent of the population who are elderly account for 26 percent of the physician office visits, 35 percent of hospital stays, 34 percent of the drug prescriptions, and 38 percent of the emergency medical service responses.

Among the salaries for physician specialties, geriatrics are at the medium range at about $163,000 annually, although geriatric physicians are among the most satisfied among doctor specialists, she said.

Magaziner, professor and chair of the School of Medicine’s Department of Epidemiology and Preventive Medicine, said that UMB "is in an ideal position to meet the challenge posed by Dr. Bernard of preparing for the health care needs of the rapidly growing aging population. Both research and educational efforts aimed at preventing and delaying the onset of health problems and disability, and treating this growing segment of the U.S. population are needed, at the same time that we need to find ways to contain costs. We also are in a good position to provide training and direct care for this group. Our ability to mount multidisciplinary programs that involve all schools on this campus places us in a unique position to take on Dr. Bernard’s challenge."

"So, what needs to be done to prepare for our aging population?" Bernard asked the audience rhetorically. She said that the National Institutes of Health in Bethesda, of which NIA is a part, has made the following suggestions in its publication Retooling for an Aging America:

* Enhance geriatric competence of the general work force in common problems

* Increase recruitment and retention of geriatric specialists and caregivers

* Implement innovative models of care


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