Seems like old times - Editorial

Nursing Homes, Jan, 2003 by Richard L. Peck

Ever wonder why long-term care seems to be such an "out there" topic-- why American society (other than scandal-mongering journalists) seems to find it so difficult to take seriously? Ever feeel sort of left out of the cultural mainstream?

That's an old feeling, actually, for yours truly. During most of the 1980s I edited a clinical journal called Geriatrics, focusing on primary care physicians' care of the elderly. Back then we knew for certain that geriatrics was an "out there" topic not often addressed by mainstream medicine. But the "demographic imperative"--the relatively rapid aging of America--was apparent even then, so we had high hopes that interest in the topic would soon begin to take off.

And there was some progress. Thanks, for example, to a "certification in special competence" process that two major medical societies initiated in the late '80s, we saw the number of certified geriatricians double to more than 9,000 by 1998. True, the number of medical school programs offering geriatrics didn't grow all that rapidly, but those of us involved in geriatrics-related journalism figured it would be only a matter of time before youngsters flocked to this new clinical field, with its unique demands and rewards.

Now here we are in 2003, and I reflect on the publication two months ago in the Journal of the American Medical Association (JAMA) of a study that pretty well dashes these hopes. Conducted by the Association of Directors of Geriatric Academic Programs, the study found these medical school programs lagging for lack of sufficient research personnel, institutional support, or reimbursement for clinical care. The investigators found that there are only 5.5 geriatricians available for every 10,000 Americans older than age 75, yet the number of certified geriatricians is likely to fall from more than 9,000 to less than 6,200 by 2004.

What a bummer, as some of my Gen X friends like to say. For me it seems like old times, i.e., not yet times for the old.

I don't bring this up to depress the readers of Nursing Homes/Long Term Care Management, but simply to reassure them that they are not alone in feeling they're on the outside looking in. As recent events in Washington have made all too clear, we're going to remain a while longer on the fringes of American consciousness. It's just a matter of being patient and continuing to do our best until reality dawns among aging boomers and their elderly parents.

It won't be long now--and, for me, what's another couple of years on top of the 20 I've already waited.

To comment on the editorial, please send e-mail to peck0103@nursinghomesmagazine.com