Stepbrother Joe
Being Elder Rich

Coming Crisis in Health Care

category_bug_journal2.gif Contrary to what appears to be popular belief, plastic surgery does not keep anybody young. Beneath the lipo-ed, Botoxed and stretched exteriors, aging continues and with that come health problems ranging from minor but chronic annoyances to catastrophic disease.

On Saturday, The Dallas Morning News published a frightening report that will affect you and your loved ones personally.

“It’s scary; we’re about to have a major medical crisis that will overburden millions of families,” said Dr. Harrison Bloom, a senior associate at the International Longevity Center in New York…”

“’It’ll be chaotic, and the quality of care will suffer,’ predicted Dr. Meghan Gerety, a professor of medicine at the University of Texas Health Science Center at San Antonio and chair of the American Geriatrics Society.

“Health care professionals advise boomers to brace themselves: Symptoms may be misunderstood or dismissed. Diagnoses may be late. And the wrong drugs may be prescribed.”

- The Dallas Morning News, 27 August 2005

The Need For More Physicians
The reason is that there are not enough physicians trained in the ailments of old age. In 2004, there were fewer than 7,000 board certified geriatricians, which is fewer than half the number currently needed. By the year 2030, when the 65-plus population will be double what it is today, there will be about one geriatrician for every 7,665 older patients unless we can increase the number of physicians trained in that specialty.

But the odds are not good. According to The Nation’s Health,

“…geriatricians comprise only one-half of one percent of all medical educators.” To meet demand in the coming years, says The Center for Workforce Studies, “…about 2800 additional medical school graduates will be needed annually.”
- The Nation’s Health, May 2005

Considering that we currently graduate a total of about 16,000 new physicians per year, this appears to be a crisis heading for disaster.

“We’ll never have enough geriatricians, so we’re helping primary-care physicians become better at screening patients for geriatric conditions,” said Dr. Ziad Haydar, assistant chief of geriatrics at the Baylor.
- The Dallas Morning News, 27 August 2005

Although many primary care physicians, family doctors and internists care for aging patients, training in geriatrics is important because older bodies to not respond to drugs, dosages and other treatments in the same manner as younger bodies, and physicians untrained in geriatrics too often erroneously believe many conditions are inherent to old age and don't bother to treat them at all.

Cost Containment
In March this year, The New York Times reported that a “significant” number of doctors are refusing new Medicare patients and experts say that older people in the coming years and decades will receive inferior care if there is not Medicare reform.

“Lawmakers will need to adjust Medicare’s payments to realistically compensate doctors for the extra time they spend on assessing geriatric patience and coordinating geriatric care teams,” said Daniel Perry, [director of the Alliance for Aging Research.
- The Dallas Morning News, 27 August 2005

Better geriatric primary care can save a lot of money by reducing hospital and nursing home costs. Even a ten percent reduction could save more than $50 billion per year, according to Perry.

“But experts aren’t optimistic that lawmakers will reform Medicare until there’s a public outcry. And boomers may also be their own worst enemies, since they’re not inclined to admit they’re getting older.”
- The Dallas Morning News, 27 August 2005

Did you know that it is legal in the United States for any doctor, no matter what his field of study, to perform plastic surgery? And in 2004, 11.9 million plastic surgery procedures were performed. Maybe if there were not such a demand for vanity medicine, more doctors would become geriatricians.


NOTE: Maybe you already know, but I didn't so I checked definitions:

GERIATRICS – a branch of medicine that focuses on health issues of later life
GERONTOLOGY – the study of the aging process


Comments

Sadly, and consistent with what has been happening in so many of the service professions, so many enter the medical profession for reasons other than a... calling, if you will. In one SoCal group I am aware of, three geriatric-qualified physicians have recently closed their panels to new senior patients.
Geriatric patients are hard work. We don't just have a cold or a fracture or a cancer. We have those things with "complicating co-morbidity," and we make doctors who aren't called to geriatrics a little crazy.
My sister's mother-in-law reminded me yesterday of the tendency of many providers to speak and listen to the younger caregiver in the room and ignore the senior patient.
We don't need numbers of geriatricians so much as we need committed geriatricians. Numbers of committed geriatricians would be great!

Informative post Ronni--thanks
--------------------------------------------
“We’ll never have enough geriatricians, so we’re helping primary care physicians become better at screening patients for geriatric conditions,” said Dr. Ziad Haydar, assistant chief of geriatrics at the Baylor
------------------------------------------

This retraining of primary care physicians is extremely important so that they will recognize ailments that affect geriatric patients.

About 5 years ago I was misdiagnosed by my then primary care physician. I had TERRIBLE unbearable headaches (headaches unusual for me) and the doctor at first did not even want to give me an appointment but I insisted. He did a 3 minute evaluation and said that it was probably sinus or something viral. No medication prescribed.

For a few days I kept getting worse. A friend recommended her doctor, a young man with a new practice. He was attentive and ordered tests to see if I had "Temporal Arteritis" which afflicts people over 60. If left untested this condition can lead to BLINDNESS The tests revealed an extremely high SED RATE which is indicative of Temporal Arteritis. He ordered a biopsy of the temporal vein-artery in my forehead. The doctor immediately prescribed high doses of Cortisone, which gave me almost immediate relief, with some side effects, but the headaches ceased. I took the meds for about 4 months and he checked my condition frequently.

I shudder to think what would have happened if I had remained a patient of the original doctor who said "Take two aspirin and get lost"

Chancy

http://www.emedicine.com/emerg/topic568.htm
for info on Temperal Arteritis

As long as cosmetic surgery is more lucrative than other types of medical offerings, medical care costs will continue to increase, steeply. Physicians are sucked out of the less lucrative fields. We, the people, are another large part of the health care cost problem. We go in for minor ailments and insist upon having every test under the sun rather than accept that the body will either heal itself--or not. I really get upset with those who waste health care dollars (this is particularly prevalent among those who are well insured for health care) on frivolous issues.

Now, they are pushing healthcare savings accounts. In general, I expect that they will be available to, and used by, those who have been well insured in the past--and that they will have zero effect on those who have been/continue to be without healthcare plans. People working for minimum wage won't be offered the HSA's, I'm betting.

We still need universal healthcare--not for frivolous stuff, but for basic healthcare needs.

Great blog shows much information on where are health care system is leading too.

Really needs to be a lot more dialogue and action on this topic! Everything that was said in preceding info is right on target from my point of view.

The oncoming generations better pay attention to the state of health care in this country. Some need to get their priorities straight with regard to medical needs. There are only so many doctors with only so much time (which is true of so many other health care service providers) to reinforce what was said by Always Question.

There seem to be more and more Nurse Practioners and various doctor assistant types taking over some medical doctors functions; more assistant types in all rehabilitation therapies. There are pros and cons to the assistant approach; but they help fill a need.

Where do we want the medical folk to focus if there aren't enough to go around? Do we need to choose between lookin' good or feelin' good? What would you choose? I know which choice I'll want when I'm feeling bad. I'll want someone there to care for me.

Why aren't our current leaders putting forth more effort to address this issue? On second thought, I'm not sure I want this current group to touch it, lest it become even worse than they've already made it with this new Medicare "D" prescription drug plan.

I agree, money will make a difference in the health care people receive, like it or not. If you're not already aware, in many cases people who have had good private insurance coverage with an employer may find that this previously primary insurance coverage has become their secondary insurance coverage when they are forced to accept Medicare as their primary insurer at age 65. Your now secondary insurer will now cover ONLY what Medicare recognizes for coverage. So, better start paying attention to Medicare.

Some secondary insurances will offer what grocery stores call "loss leader items"(they lose money on them; make it up on other products) to attract you by providing a coverage Medicare does not. You need to know what was cut to balance that trade. If you know your body, general health state, especially special needs, you may benefit from some of these offerings. You have to do your homework. There is no easy way. Each individual insurance company has plans with benefit services as diverse as the models at any car dealership.

A pet peeve of mine is, that health care plans including Medicare, for the most part do not provide for our most basic fundamental needs if we develop a sensory impairment and need eyeglasses (contact lenses?,) hearing aids, dentures. Only with some very specific but limited medical diagnoses are these needs met.

We have so many middle people between the patient and the provider now, it's an act of major mathematical proportions to divide up how much each person gets out of a fee for service.

Here we are, the greatest nation in the world for how many years? And we can't even seem to take care of our own people, the ones with health insurance coverage as well as those without.

Who said, a nation is judged by how well they take care of their weakest and poorest, or words to that effect?

I surely wish some leaders would come forth to seriously address these health care issues in my lifetime. All of us really need to vocalize to make it happen.

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