- The Washington Times - Friday, May 10, 2002

When Marie Brown's 97-year-old mother fell and broke her hip two years ago, it started the family on an often-frustrating quest for appropriate medical care.
Doctors unfamiliar with the health issues of the elderly initially put Mary Holmes, then 94, on bed rest. That weakened her muscles so her knees no longer could bend. The D.C. woman became permanently bedridden.
"She just got depressed. She was just laying there," said Miss Brown.
Frustrated with the care her mother was receiving, Miss Brown, 65, began searching for medical professionals trained to deal with the elderly.
For the past year, her mother has been working with a geriatric team from the Washington Hospital Center that comes to the house and provides medical care and therapy.
"Unfortunately, when you go to a non-geriatric doctor, they give you a pill and send you home," Miss Brown said.
"The people who are trained really pay attention to what's happening to you."
Geriatricians are doctors with expertise in caring for older people. Most are trained in family practice or internal medicine, but have completed one additional year of fellowship training in geriatrics and have passed a certifying exam.
"Training in geriatric medicine can help save or improve the lives of people who still have much to give," said Dr. Charles Cefalu, director of geriatric program development at Louisiana State University.
Health officials are sounding the alarm that in a country where the number of elderly is on the rise, too few health providers are knowledgeable about aging issues.
They want Congress to address the issue this year as lawmakers write far-reaching Medicare-reform legislation.
"The shortage of geriatric-trained health care professionals is reaching crisis levels," said Sen. John B. Breaux, Louisiana Democrat and chairman of the Senate's Special Committee on Aging.
The United States should have 20,000 geriatric-trained physicians to provide adequate care for the 35 million older people in this country, says the Alliance for Aging Research, an advocacy group.
But fewer than 9,000 of the nation's 650,000 licensed physicians have met the qualifying criteria in geriatrics, and that number is expected to drop to as few as 6,100 by 2004, the alliance said in a recent report.
Reasons for the shortage vary and include a lack of geriatric curriculum at medical schools. But officials say topping the list is Medicare's paltry payments for doctors who care for the elderly. This year, doctors treating Medicare patients learned their payments would be cut 5.4 percent.
The cut would cost a geriatrician $30,630 a year, according to the American College of Physicians. A four-physician geriatrics practice would lose $122,520 a year, the group estimated. For those practices, the cuts could mean laying off nurses and clerical workers.
Doctors are lobbying Congress to restore the money.
The problem is coming just as the number of Americans 65 and older is expected to more than double to 70 million by the year 2030.


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