Study: health workforce not ready for aging boomers

WASHINGTON -- Leading-edge baby boomers will confront a " woefully unprepared " healthcare workforce when they reach age 65 in 2011, triggering a potential crisis in health care, a new study asserts.

Today's healthcare workforce is too small and is ill-prepared for coming explosion in health and wellness needs from the nation's 78 million baby boomers, says a new report from Institute of Medicine. The report, " Retooling for an Aging America: Building Health Care Workforce, " calls for bold initiatives starting immediately to train all healthcare providers in basics of geriatric care.

The committee that authored the report also calls for a crash program to prepare family members and other informal caregivers, " who currently receive little or no training in how to tend to their aging loved ones, " according to the institute.

" We face an impending crisis as growing number of older patients, who are living longer with more complex health needs, increasingly outpaces number of healthcare providers with knowledge and skills to care for them capably, " said John Rowe, professor of health policy and management at Columbia University's Mailman School of Public Health, who chairs the IOM committee.

" The sheer number of older patients in coming years will require trying new models for delivering health care and commitment of greater financial resources, " Rowe added. " If our aging family members and friends are to live as robustly as they can and in best health possible, we must have a workforce of adequate size and competency to take care of them. "

Several reports show an overall shortage of healthcare workers in all fields, authors noted, but situation is worse in geriatric care " because it attracts fewer specialists than other disciplines and experiences high turnover rates among direct-care workers. "

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Exacerbating shortage is unequal levels of pay for healthcare professionals dedicated to treating older Americans. " Salaries of doctors, nurses, pharmacists, social workers and others who specialize in geriatric care lag behind those of their counterparts in other fields, " IOM stated. For instance, " A geriatrician earned $163, 000 on average in 2005 compared with $175, 000 for a general internist, despite the extra years of training required for a geriatric career. Physicians who choose dermatology can earn over $300, 000 a year. Registered nurses who work in nursing homes or other long-term care facilities earn less on average than their counterparts, despite working longer hours with more overtime. "

The study's authors fault Medicare program, whose " low reimbursement rate for primary care is foremost reason that geriatric specialists earn lower salaries, given that so much of their income comes from the government program. "

Medicare should increase its reimbursement rates for services delivered by geriatric specialists, the report urges.

Shortages of healthcare workers to treat conditions related to aging already are a problem, according to report. " There are just over 7, 100 physicians certified in geriatrics in United States today -- one per every 2, 500 older Americans, " IOM states. " Turnover among nurse aides averages 71 percent annually, and up to 90 percent of home health aides leave their jobs within first two years. "

In its report, the committee urges that all health professional schools and healthcare training programs expand coursework and training in treatment of older individuals. The authors also recommend that Medicare change its focus, from " treating short-term health problems " to " managing chronic conditions or age-related syndromes. The program should also shift its coverage to focus more on preventive services and a more collaborative approach to health care, involving doctors, nurses, pharmacists, caregivers and patients themselves.

The report also urges that states provide tax incentives for nonprofit hospitals and other entities to train those who care for elderly. " In addition, federal agencies should support advancement of assistive technologies that can help older patients manage their conditions and handle basic activities of daily life and also can help informal caregivers take care of their loved ones, " IOM stated.

More than 90 percent of older adults who receive care at home rely in part on informal caregivers, and nearly 80 percent rely solely on family or friends. However, little is done to ensure informal caregivers have necessary knowledge and skills. "

The committee set a target date of 2030 -- year by which all baby boomers will have turned 65 or older -- for the necessary reforms to take place.

JIM FREDERICK

SENIOR EDITOR

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