NYU Winthrop Hospital, Mineola, USA.
State University of New York at Stony Brook, USA.
J Aging Health. 2020 Oct;32(9):1052-1062. doi: 10.1177/0898264319879325. Epub 2019 Oct 4.
Geriatricians are skilled in the recognition of asymptomatic and atypical presentations that occur in the elderly and provide comprehensive medication management including recognizing adverse drug events, reducing polypharmacy, and de-prescribing. However, despite the increasing average age of the U.S. population, with the number of individuals above 65 years old predicted to increase 55% by 2030, the geriatric workforce capacity in the United States has actually decreased from 10,270 in 2000 to 8,502 in 2010. We describe physiologic changes in older adults, historical trends in geriatric training, and propose solutions for this looming crisis. Many factors are responsible for the shortage of skilled geriatric providers. We discuss the historical context of the lack of geriatricians including changes to the training system, describe the impact of expert geriatric care on patient care and health system outcomes, and propose methods to improve recruitment and retention for geriatric medicine.
老年医学专家擅长识别老年人中无症状和非典型表现，并提供全面的药物管理，包括识别药物不良反应、减少多种药物并用和撤药。然而，尽管美国人口的平均年龄不断增加，预计到 2030 年，65 岁以上人口将增加 55%，但美国的老年医学劳动力能力实际上从 2000 年的 10270 人减少到 2010 年的 8502 人。我们描述了老年人的生理变化、老年医学培训的历史趋势，并提出了解决这一迫在眉睫的危机的方案。许多因素导致熟练的老年医学提供者短缺。我们讨论了缺乏老年医学专家的历史背景，包括培训系统的变化，描述了专家老年护理对患者护理和卫生系统结果的影响，并提出了改善老年医学招聘和留用的方法。
