Geriatrics in the United States

Demographic projections indicate that the elderly segment of the U.S. population will grow substantially over the next 50 years, posing additional requirements for medical geriatrics manpower. This report provides quantitative boundary estimates of these requirements under four models: continuation of the status quo; academic geriatricians only; academic and consultant geriatricians; and academic, consultant, and primary care geriatricians. Each option is further analyzed in terms of three levels of delegation to nonphysician caregivers. Quantitative implications are projected through the year 2030 under present levels and allowing for improved care of either the 65+ or 75+ age group. The need for geropsychiatric care is explored separately. Given a scenario in which both consultant and some primary care is provided to the 75+ group — with moderate delegation to nurse practitioners, physician assistants, and social workers — and in which allowance is made for a geriatric academic role, the authors estimate that between 7,000 and 10,300 geriatricians will be required by 1990, the best intermediate figure being 8,000.