LA Times on Boomers' Strain on Healthcare System

Healthcare system unprepared for aging boomers, study finds

The federal report predicts shortages in medical workers, particularly those certified in geriatrics. California's situation is particularly dire.

Maria L. La Ganga
Staff Writer - Los Angeles Times
April 15, 2008

The American medical system is woefully unprepared for the flood of aging baby boomers, according to a sweeping federal study released Monday, which predicted crisis-level shortages in healthcare workers and serious gaps in training.

The Institute of Medicine report -- "Retooling for an Aging America: Building the Health Care Workforce" -- estimates that there currently is only one physician certified in geriatrics for every 2,500 older Americans and that turnover among nurse's aides averages 71% annually.

In California, the situation is even more dire.

Although the institute's study focused on the national picture, a state legislative report estimated that there is only one geriatrician for every 4,000 Californians age 65 and older. In addition, only 3% of social work students specialize in gerontology, only 5% have taken a course on aging, and the state faces a shortfall of 30,000 certified nursing assistants who care for the frail elderly in convalescent homes, according to the California Strategic Plan on Aging Advisory Committee.

Although California's median age is one of the lowest in the country, according to the Census Bureau, there were nearly 4 million residents age 65 and older in 2006; that number is expected to more than double by 2030. Florida had just over 3 million residents 65 and older in 2006.

"Just at a time when we need more [geriatricians], we're getting slightly fewer of them," said John Pynoos, professor at USC's Andrus Gerontology Center, who was not a part of the report released Monday. "This is a crisis. . . . In California, we're already behind the curve."

Although older Americans will have less chronic disability and live longer than in the past, their numbers will be so great that they will swamp the healthcare system, the report said. In addition, they tend to have more complex conditions and healthcare needs than younger patients. The first of the 78 million baby boomers will turn 65 in three years. By 2030, all will have hit that milestone, and the number of adults 65 and older will have almost doubled -- from 37 million in 2005.

The institute report said that there were 7,128 certified geriatricians today, and that the nation would need 36,000 by 2030. Optimistic estimates say the number of geriatricians will rise by only 10% in the next 22 years; others predict a net loss.

"There will never be enough geriatricians," said Dr. Joseph Scherger, a clinical professor of family and preventive medicine at UC San Diego, who served on the committee that researched and wrote the report."

The majority of the primary care of seniors is going to be done by general internists and family physicians," Scherger said in an interview Monday. "Having a good geriatric knowledge base and skills is critical."