Monday, January 08, 2007
Why be a Geriatrician?
Kevin MD links to this article discussing the shortage of geriatricians:
Today, there is about one geriatrician for every 5,000 adults ages 65 and older. By 2030, the American Geriatrics Society estimates that while the population of older adults will have doubled to 70 million, the proportion of geriatricians will have dropped to one doctor per 7,665 people.
Geriatric care is a lot of fun, but it's never been glamorous and no one perceives it as fun. It's very challenging. There are a lot of issues to be dealt with. I think the real key is to find young physicians who share that interest and are willing to make that the focus of their careers. : makes going into geriatric care less appealing for medical students? : think it would be fair to say (that salary for a starting geriatrics specialist is) roughly a third of what a starting cardiologist would make. The typical medical school graduate is finishing med school with $100,000 to $200,000 in debt.
Other than those wanting to enhance an academic career, I can't understand why anyone would want to do a geriatrics fellowship (which is an additional 1 year beyond the standard 3 year internal medicine residency). Internal medicine residency training is sufficient for developing the necessary knowledge and skills to take care of geriatric patients.
For non-academic physicians, a geriatrics fellowship is an additional year of training (and receiving a low resident/fellow's salary) with no payoff at the end. In fact, because of low Medicare reimbursement, a geriatrician in private practice will make less money than a general internist who sees both young adults and geriatric patients.
Being a medical director of a nursing home can be profitable, but this can also be done by a general internist.
I'm all in favor of education and enjoy learning about about the wide field of medicine, but at some point a person needs to begin earning a living, and a geriatrics fellowship is an unnecessary delay in this process.