Tuesday, April 15, 2008

Bursting Boomers

From a recent news article from the APA:

NBC Nightly News (4/14) reported that "there's a new warning that this nation's medical care system for seniors is nowhere near ready to deal with the 78 million Baby Boomers who are about to begin turning 65," according to a study by the federal Institute of Medicine (IOM), which is part of the National Academy of Sciences.

The 242-page publication states that "[h]ealthcare institutions must rapidly increase training in geriatric care to ward off an 'impending crisis,'" the Wall Street Journal adds. In fact, the report characterizes "the U.S. healthcare workforce [as] 'too small and woefully unprepared' for the growing elderly population," and portrays "a stark picture of increased demand for healthcare workers -- unmet by a stagnant, or even dwindling, supply of those trained to treat the elderly." According to John W. Rowe, chairman of the committee which compiled the data, and former chairman and chief executive of Aetna, Inc., "This could be seen as evidence that our society places little value on the expertise needed to care for vulnerable, frail, older Americans."

The study found that currently, there are insufficient "specialists in geriatric medicine," training is inadequate, and the few "specialists that do exist are underpaid," the AP reports. In fact, the investigators charge that "Medicare may even hinder seniors from getting the best care, because of its low reimbursement rates, a focus on treating short-term health problems rather than managing chronic conditions, and lack of coverage for preventive services or for healthcare providers' time spent collaborating with a patient's other providers."

The data also indicate that since "one out of five Americans will be 65 or older" by 2030, "Medicare, Medicaid, and other health plans will need to pay higher rates for the services of geriatric specialists and direct-care workers to attract more health professionals to geriatric careers".

A crisis looms on the horizon. Are we preparing? Sadly, the answer seems, no. Less doctors are accepting Medicare, due to declining reimbursements. Nursing and Continuing Care Facilities are not likely to keep up with the need of the populations, especially for the lower income groups.

Physicians themselves do not appear well prepared for this burgeoning population. Geriatric patients require more time, due to a higher level of complexity from multiple medical concerns, a greater variability in responses and side effects from treatment, and difficulty with communication. Greater time needs to be spent collaborating with families and coordinating with other physicians. If the numbers noted above are correct, it's time to start preparing....

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