The recruitment of health care professionals to become geriatric specialists is often hindered by a simple lack of opportunity. As discussed previously, many professionals have neither adequate introduction to geriatrics nor opportunities for advanced training in the field. While GME supports the general training of physicians in geriatrics, workers in other professions often lack the opportunity for advanced training in geriatrics, usually because there is not enough funding for the programs or not enough funding for salary support.
Indeed, this is part of a pattern that extends far beyond geriatrics. Generally speaking, with the exception of physicians, few professionals have significant support for advanced training. In response, some efforts have arisen in recent years to increase the training opportunities for these professionals. The Medicare program, for example, not only supports the training of residents but has made some payments to hospitals for its share of the direct costs of nursing and allied health training programs. In 2001 Congress introduced the All Payer Graduate Medical Education Act,12 which would collect additional GME funds through a 1 percent tax on private health plans. Part of this revenue was directed toward the graduate education of “non-physician health professionals” (AAMC, 2007b). The Nurse Education, Expansion, and Development Act13 proposes to provide grants to nursing schools, in part, to develop “post-baccalaureate residency programs to prepare nurses for practice in specialty areas where nursing shortages are more severe.” These measures are for the training of professionals in general, however, and do not necessarily support advanced geriatric training.
In the area of geriatrics, advanced training programs for professionals other than physicians often must look to private foundations for support, or else it falls to the individual students to pay for the programs without any source of subsidy. For example, in 2007 the John A. Hartford Foundation awarded a $5 million renewal grant to the Gerontological Society of America for the purpose of preparing doctoral students in geriatric social work (The John A. Hartford Foundation, 2007).
Financial burdens create great challenges in the recruitment and retention of all types of professionals.