Training Physicians to Care for Older Americans Progress, Obstacles, and Future Directions (1994) / Chapter Skim
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2 GERIATRIC MEDICINE AND GERIATRICIANS
2 GERIATRIC MEDICINE AND GERIATRICIANS
Pages 3-13
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From page 3... ...
The American Geriatrics Society is a professional organization and its members primarily comprise physicians, while the Gerontological Society of America was designed to serve a much broader constituency. The founding of the societies was coincidental with the recognition that almost 7 percent of the population was over age 65 in the 1940s as well as the realization that the care of elderly people was a multidisciplinary process.
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From page 4... ...
Between these extremes lie nursing homes, board and care facilities, physicians' offices and ambulatory care clinics, day hospitals, other partial hospitalization arrangements and day-care centers, geriatric evaluation units both ambulatory and institution-based, geriatric rehabilitation facilities, a variety of congregate housing arrangements that are integrated with the provision of health care, and other alternatives that have yet to be developed. Several decades ago, discussions about the care of elderly people led to a striking dichotomy of views.
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From page 5... ...
The demographic changes will create a greater demand for physician care. According to projections based on 1989 physician contact rates and projections for the noninstitutionalized elderly population, the demand for physician contacts will increase by 22 percent (from 259 million to 296 million contacts)
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From page 6... ...
The availability of periodic preventive services, referrals to specialized services, long-term and terminal care, and centralized comprehensive medical records is essential for such primary care. There appears to be consensus on the view that the care of the elderly population should primarily be the responsibility of appropriately trained primary care physicians.
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From page 7... ...
They emphasized that the skills, attitudes, and values of the nation's 10 million health care workers have a fundamental impact on health care. The kind of care that health professionals provide, how they provide it, what they value, how they interact with patients, how they define quality, and how efficiently they work determine to a great extent the quality, cost, and availability of health care.
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From page 8... ...
CERTIFICATION OF GERIATRICIANS Beginning in 1988, the American Boards of Internal Medicine and Family Practice jointly offered a certifying examination for a Certificate of Added Qualifications in Geriatric Medicine (CAQGM)
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From page 9... ...
that allows diplomates who can document at least 4 years of substantial practice experience involving elderly patients to sit for the examination (subspecialty certification has been accepted as the equivalent of 2 years of substantial practice experience) (Steel et al., 1989~.
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From page 10... ...
Approximately 284 geriatric medicine fellows have been supported since 1982, and total estimated support has been $27.7 million. In 1991, DVA began training geriatric psychiatry fellows at nine sites, and 12 psychiatrists had graduated as of June 1993.
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From page 11... ...
According to recent figures provided by the National Study of Internal Medicine Manpower, a considerably higher percentage of graduates of geriatrics fellowship programs enter full-time academic positions compared with graduates of cardiology and pulmonary fellowship programs (Table 2~.
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From page 12... ...
The low publication rate among the graduates surveyed also suggests that scholarly research activities might not have been optimally pursued during their training. TABLE 2 Activities of 1991-1992 Graduates of Geriatrics, Cardiology, and Pulmonary Fellowship Programsa Percentage Activity in the Geriatrics Cardiology Next Year Fellows Fellows Pulmonary Fellows Continued training 15 16 15 Full-time academic 37 22 25 position Full-time practice Outside hospital 27 48 44 Hospital position 12 5 7 Other 10 8 8 aData are based on National Study of Internal Medicine Manpower Study data (Kohrman et al., in press)
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From page 13... ...
More than 60 percent reported currently active participation in research, and 85 percent reported that they did some teaching in geriatric medicine. A nationwide survey of geriatrics faculty in five specialties (internal medicine, family practice, neurology, physical medicine and rehabilitation, and psychiatry)
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