It seems that when healthcare is advertised, markets gravitate towards billboards of children, adolescents and young adults. This marketing strategy ignores a large portion of the United States: the elderly. The baby boomer generation is now approaching retirement age, so what exactly does that mean for America? By 2035, the number of elderly people is projected to outnumber children for the first time in U.S. history. Needless to say, this demographic takes up a significant portion of our population, but the U.S. consistently underperforms in the area of geriatric medicine. When most people reach the age of 65, they are eligible for Medicare, thus making the geriatric population the only age group covered universally by health insurance. Why, then, does the U.S. rank so poorly in geriatric care compared to other Organisation for Economic Co-operation and Development countries?
Recently, it has become more common for primary care physicians (PCPs) to avoid caring for geriatric patients. With the ever-increasing responsibilities of PCPs in modern healthcare, it makes sense that the first vulnerable population to be sidelined would be geriatric patients. Contrary to popular belief, what we need right now is not PCPs. We need geriatricians, doctors that specialize in elderly care. But that’s not what’s happening.
Despite the growing number of older people, geriatric fellowship programs are struggling to fill slots even though the elderly desperately need this specialized care. While PCPs like family doctors are excellent at providing care to older people, the New England Journal of Medicine cites three reasons why geriatricians’ specialized skills are absolutely integral. First, they are trained in age-related physiological processes and clinical diseases. Second, they have a holistic approach to care, which is absolutely essential given that geriatric patients are more prone to having multiple chronic illnesses. Third, they are skilled in the art of shared decision-making where they take into account patient preferences and values. These skills are acquired during geriatric fellowships, which is why they are so important. Recently, the Trump administration slashed funding for already dwindling geriatric training budgets. We need more geriatricians if we want to provide optimal care for the elderly.
The elderly are likely the most economically vulnerable population in the country, with nearly 22 percent of all seniors spending $2,000 a year in out-of-pocket costs. In the United Kingdom, Norway, and Sweden, less than five percent of patients said they were financially struggling, compared with a quarter of Americans in the same cohort. Our system is ill-equipped to treat the elderly, and we owe it to them to do better.