The American health-care system is under-equipped to serve the rapidly aging generation of baby boomers, according to a recent report from the Institute of Medicine, and medical schools must step up.
While some schools, like Penn, have developed programs to improve training in geriatric medicine, it's still a challenge to get students to specialize in the field.
Although the number of Americans over 65 is projected to double by 2030 - bringing it to about 75 million - the number of geriatricians in the country has actually declined in recent years, according to the report.
"Most professional education programs still do not have sufficient geriatric content in their curricula or adequate experiences in clinical settings," the report says.
Penn's School of Nursing "has been one of the leading schools in the country to develop programs in geriatrics and to focus on geriatrics," said John Rowe, the report's lead author and a professor at Columbia University's School of Public Health.
Still, geriatrics is not an overwhelmingly popular specialty.
Mary Dawn Hennessy, a sixth-year graduate student in the Nursing School specializing in women's health, says just two students in her graduating cohort of 16 chose geriatrics as a specialty.
Lisa Bellini, a professor of medicine at Penn, estimates that about 3 percent of her residents has gone into geriatrics over the past 10 years.
John Burton, director of the Johns Hopkins Geriatric Education Center, attributes the low interest in the speciality to three aspects of geriatric care: low pay, low prestige and high labor intensity.
"It takes a particular type of individual to go into that," said Hennessy. "It's kind of messy - people's body functions don't work as well - and you need a lot of patience."
The Institute of Medicine report also recommends that licensed health-care professionals be required to show they can care for the elderly, and that the government expand training and financial incentives for health-care workers in geriatrics.
John Trojanowski, who directs Penn's Institute on Aging, predicts a "tsunami of Alzheimer's" and other degenerative diseases, saying the health-care workforce is "ill-prepared for the longevity revolution that we're in the midst of."
Health-care experts have anticipated the looming deficiency in geriatric care-givers and researchers for several decades now, according to Burton, but "the federal government has been asleep at the switch" instead of aggressively trying to recruit and retain geriatric specialists.
Furthermore, he said, the situation is complicated because "you can't legislate people into special segments of practice; they make their own choices."
Instead, many medical schools and independent foundations have been steadily striving to improve education about geriatric health. Penn's Institute on Aging was founded in the 1970s, alongside similar programs at other schools, according to Trojanowski.
The Institute gives grants for aging research, and hosts lectures and conferences.
Its activities have raised awareness of the geriatric-care crisis, said Trojanowski, but "like other things that require social commitment to deal with, it's not enough on people's radar screens yet."
