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Training Physicians to Care for Older Americans: Progress, Obstacles, and Future Directions
geriatrics. Included among these were foundation support for medical student research programs in geriatrics and gerontology and financial stimuli, including low-interest loans for those starting academic careers in geriatric medicine and loan-forgiveness programs for physicians entering training programs in geriatric medicine. The report recognized the need for a marketing effort to create positive attitudes about the importance of geriatrics and the major opportunities that exist in this area; it noted that complementary efforts should be taken to increase the public's awareness of geriatrics as well. In addition, the report recommended that geriatric medicine faculty be protected from excessive clinical obligations.
The report recommended several revisions in payment policies, including separate payment codes for planning and coordinating services for frail elderly patients, the provision of appropriate payment for all health professionals on geriatric teams, and inclusion of nonhospital settings as part of the payment formula used in calculating Medicare 's indirect medical education adjustment. Finally, the report recommended increased federal funding for academic and research activities in geriatric medicine.
With that report, the Institute of Medicine outlined a framework and strategy for strengthening training in geriatrics for physicians that may guide health policy decisions in federal and state governments. It may also help foundations to determine priority areas for funding programs in geriatrics. Finally, it helps to provide an inventory for the academic geriatrics community to take stock of its current strengths and weaknesses and plan for the future.