After four years of medical school and three years of internal medicine training, Jessica Colburn could have chosen just about any field of medicine to practice. Gastroenterology would have been lucrative, brain surgery exciting. At one point, pediatrics piqued her interest.
But Colburn, 31, picked one of the least-popular areas of medicine to make her mark: geriatrics.
"I've always loved old people," said Colburn, chief resident at the Johns Hopkins Bayview Internal Medicine Residency program. "And I have been interested in the care of underserved people. I think it's a need and a demand in medicine."
As baby boomers age, the demand for geriatricians - internal- or family-medicine doctors trained in the needs of elderly patients - will only grow.
There is now only one geriatrician for about every 2,500 Americans over age 75, and experts in the health care industry expect the shortage to worsen.
"Every place it's a problem," said Dr. Colleen Christmas, assistant professor of medicine in the division of geriatric medicine at the Johns Hopkins School of Medicine.
"In Baltimore, it's not as bad, but there are pockets of Maryland where you just can't find a geriatrician. On the Eastern Shore, for instance, it's very, very hard to find anyone with any extra training in the field."
Experts attribute the shortage in part to the required additional training, coupled with the lower pay relative to other physicians.
Sen. Barbara Boxer, a California Democrat, has sponsored legislation to provide incentives for medical students and other health care workers to focus on geriatrics and gerontology, the study of aging.
The legislation would provide $130 million in federal funding over five years to attract and retain trained health care professionals and direct-care workers such as nurses, by providing them with loan forgiveness and career advancement opportunities.
"If there is not a sufficient number of providers trained to care for older adults, then older adults will be at risk for not getting the care they need," AARP said in an April report to the Senate Special Aging Committee. "This in turn could lead to increased health care costs and poor patient outcomes."
The role of prescriptions
One reason for the increased cost: prescription drugs.
"The costs of drugs are tremendous in this age group," Christmas said. "Most have two to three diseases at once."
