Training Physicians to Care for Older Americans

Book excerpt: This background paper, prepared by two members of the Institute of Medicine's Committee on Strengthening the Geriatric Content of Medical Education, addresses the progress made in physicians' geriatric and gerontological education. The report appears in six chapters. After a brief introduction on health care reform and medical education, geriatric medicine and geriatricians are discussed in chapter 2. Some of the topics examined here include the historical development of geriatrics, physician certification, and the utilization and financing of health services. Chapter 3 analyzes past efforts to develop geriatrics and explores increases in geriatric faculty, geriatric fellowship programs and residencies, continuing medical education, and obstacles to the development of academic geriatrics. Chapter 4 assesses the demand for geriatricians and faculty, while in chapter 5, some strategies to strengthen physicians' geriatrics training are presented. Some of these strategies include revised financial policies, the revamping of service delivery, the strengthening of faculty development and academic programs, and recruiting and marketing ideas. The last chapter comments briefly on the 1993 Institute of Medicine Report. The recommendations made in the above report were grouped into five categories: (1) improved education in geriatrics; (2) leadership centers; (3) enhanced attractiveness of geriatrics; (4) revision in payment policies; and (5) research support. (RJM)