Changes Needed to Prepare Doctors to Care for Aging America

Leading physician policy experts are calling for changes in medical education policy at multiple levels to ensure that doctors are prepared to treat the country's aging adult population.

In Health Affairs, coauthor Steven R. Counsell, MD, Mary Elizabeth Mitchell Professor and director of geriatrics at the Indiana University School of Medicine and a Regenstrief Institute affiliated scientist, and colleagues propose several policy solutions to help the United States prepare for the increasing number of geriatric patients.

"The geriatric imperative of the 21st century requires major, rapid changes to our healthcare system," says Counsell. "Through educational policy reforms at the state and federal levels, policymakers can catalyze the dramatic workforce changes necessary for delivery of cost-effective chronic care to the rapidly swelling ranks of older Americans."

The article proposes multiple policy-driven solutions. Leading physician policy experts are calling for changes in medical education policy at multiple levels to ensure that physicians are ready to treat the country's growing older adult population.

To ensure a better trained physician workforce as the demand for geriatric care increases and the number of geriatric specialists decreases, policy options proposed by the authors include the following:

• 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

The authors propose 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.

Similarly, the Medicare program, which provides teaching hospitals with large annual subsidies for graduate medical education, could make continued educational funding contingent on rapid reforms in the training of resident physicians and specialty fellows. To drive swift educational reform, new Medicare policy could link a significant portion of the teaching hospitals' annual direct and indirect medical education payments to the amount of training they provide in primary care, chronic care and geriatrics.

To support continuous geriatrics training of the many physicians already in practice, the authors propose that state policies require geriatric continuing education credits for physicians to maintain their licensure, or to practice as Medicaid providers or medical directors of nursing homes.

Source: Indiana University School of Medicine