The Urgency Of Preparing Primary Care Physicians To Care For Older People With Chronic Illnesses

The Urgency Of Preparing Primary Care Physicians To Care For Older People With Chronic Illnesses

Chad Boult1 , Steven R. Counsell2 , Rosanne M. Leipzig3 , and Robert A. Berenson4

PUBLISHED:May 2010 Health Affairs>Vol. 29, No. 5: Reinventing Primary Care

https://doi.org/10.1377/hlthaff.2010.0095

Abstract

Population trends are driving an undeniable imperative: The United States must begin training its primary care physicians to provide higher-quality, more cost-effective care to older people with chronic conditions. Doing so will require aggressive initiatives to educate primary care physicians to apply principles of geriatrics—for example, optimizing functional autonomy and quality of life—within emerging models of chronic care. Policy options to drive such reforms include the following: providing financial support for medical schools and residency programs that adopt appropriate educational innovations; tailoring Medicare’s educational subsidy to reform graduate medical education; and invoking state requirements that physicians obtain geriatric continuing education credits to maintain their licensure or to practice as Medicaid providers or medical directors of nursing homes. This paper also argues that the expertise of geriatricians could be broadened to include educational and leadership skills. These geriatrician-leaders could then become teachers in the educational programs of many disciplines. This would require changes inside and outside academic medicine.

TOPICS

Chronic care| Physicians| Medical education| Primary care| Education| Internal medicine| Physician workforce| Elderly patients| Chronic disease| Medicare savings programs