Recently articles in the medical literature shed light on an important shortage besides nephrology- geriatricians. Geriatric medicine was founded as a specialty in 1988 and a fellowship track was created. With the baby boomers growing older and human lifespan expanding, multiple medical problems, geriatric medicine is an important field of medicine that should attract many applicants. But just like Nephrology, there is a major workforce shortage the geriatricians are facing today in the United States. Why is that and can this field survive?
Apparently, just like Nephrology, geriatric medicine is an unpopular career choice for medical students and residents due to perceived low prestige, low salaries and complicated patients. Nephrology has many older patients, not very high salaries and similarly complicated patients to take care of. American Society of Nephrology has created a committee on the Workforce shortage and ways to come up with ideas on how to increase interest in Nephrology. You can watch a recent video clip from ASN regarding this.
The article in annals proposes potential solutions on how to increase interest in geriatrics and improve geriatrics care. Perhaps Nephrology can learn from them
The suggestions are:
1********Geriatric focus models (ACOs) might help relieve some of that frustration. A similar proposal has been made in Nephrology.
2********* “Gerontologize” teaching incentives. If the residents and medical students are not taking geriatrics as careers and fellowships are vacant, then perhaps energy should be redirected in geriatric educational resources towards teaching non geriatricians to be better geriatricians. Nephrology is part and parcel of UGE and GME- unclear if this strategy will work in our field. Will there ever be a point in time when general internists might have to do some basic nephrology care given lack of experts in the field. In parts of the world, pediatric nephrologists are only found in academic centers, and initial treatments of many diseases including nephrotic syndrome is initiated by general pediatricians.
3******** Train non geriatricians in geriatric medicine to deliver this education to the UGE and GME. It appears that the field of geriatrics is not really focusing on how to increase interest but to shift gears and allow others to take charge and teach and practice geriatrics as part of their general medical practice. Given there is technical issues with dialysis and immunosuppresion management in transplantation, would a general internist be comfortable? Hard to see this happen in Nephrology
“It appears that if there is no increase in compensation, or professional recognition, the field of geriatric medicine is in for extinction.” – The article states. Should society needs and demands be considered when making career choices? The society is going to need geriatricians and nephrologists, there is going to be a major shortage. Students in medicine and residents in medicine, should try to consider these fields of choices as they will be fulfilling a major need for the society as well.