"Yes, the number of patients who are in that age category are clearly increasing. As we live longer, naturally there will be more patients in that age category," says Dr. Michael Jedlinski, an internal medicine physician at Saint Francis Medical Center. "I hope that there are enough qualified physicians to take care of the aging population. I'm concerned that we may not be able to provide the care that may be required as a consequence of a shortage of physicians available throughout the community and the nation."
Jedlinski says while the number of students graduating from medical school has remained constant, those specializing in primary care have declined -- perhaps because they aren't interested in the specialty or have observed the difficult hours that primary care physicians often work. Primary care may not be as "financially attractive" as other specialties, he adds, especially considering the amount of debt that most students have after school. Still, there is a "limited response at this point" to the situation, says Jedlinski.
"I am not aware of any recent increase in federal incentives to medical schools to increase graduation rates," he says. "The decrease in the number of physicians who choose to practice primary care will have a significant negative impact in the future as far as patients not being able to find a doctor."
But with an increasing life expectancy in the United States, and more medications and treatments available to prolong life, the need for physicians to care for seniors will only continue to grow -- especially if those seniors want to enjoy a high quality of life. And who doesn't?
"As they live longer, more people will hopefully be able to remain independently in their own homes, and there needs to be a greater emphasis on helping patients remain active in their homes," says Jedlinski. "Right now, that structure is not put into place. As we look at health care reform, an area that needs to be addressed is how can patients be helped to maintain active, independent lives outside of the traditional institutional settings."
Dr. Mourad Nessim of Southeast Internal Medicine believes a relationship between patients, families and physicians is the key to caring adequately for seniors.
"The message is that elderly people need care and they need to be proactive, and the family needs to be proactive in seeking care, too. It's a team approach," says Nessim. "We all try to give a good quality of life as long as we can. We will need more physicians in the future."
Nessim recently began seeing patients once a week at Chateau Girardeau, handling everything from one-time needs to routine care for diabetes.
"A lot of people don't have transportation or they need family members to take them to the doctor. This helps the patient and the family," says Nessim. Of his multifaceted approach to caring for seniors, Nessim says, "We try to look at geriatric patients not exactly as a chronological age but as a functional status. On the first evaluation we come up with a comprehensive plan involving the family and other professionals, like social workers. We try to look at older patients as needing different areas of care like finances, social issues, transportation -- it's not just health. They can be healthy but very isolated, so we try to help coordinate their care."
As Nessim cares for patients at his practice and at Chateau Girardeau, he says he's also preparing himself to handle the expected rise in elderly patients.
"I'm trying to educate myself as time goes by. As an internal medicine physician, a bigger portion of my patient population is going to be elderly rather than young and healthy people," he says. "As I'm getting older myself, I'm caring for older patients."