Giuseppe Bellelli, MD; Marco Trabucchi, MD
Potential Conflicts of Interest: Dr. Bellelli: Payment for lectures including service on speakers bureaus: Novartis. Dr. Trabucchi: Payment for development of educational presentations: Novartis.
Bellelli G, Trabucchi M. Dialogue on Geriatrics: How Should We Fix the Problem?. Ann Intern Med. 2012;157:458. doi: 10.7326/0003-4819-157-6-201209180-00021
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Published: Ann Intern Med. 2012;157(6):458.
TO THE EDITOR:
We read with great empathy the In the Balance article by Leipzig and colleagues (1) on the dramatic inadequacy of a geriatric workforce facing the increasing number of older persons in the United States. If possible, the state of this crisis is worse in Italy than it is in the United States because we will never be able to reach the required number of geriatricians. (The population of Italy is about one fourth that of the United States, and we hypothesize that we will need about 6500 specialists by the year 2030.) In fact, our academies graduate about 120 geriatricians a year, a rate barely sufficient to balance turnover. Taking into account the economic crisis involving all sectors of our society, it would be unrealistic to plan a swinging increase in the numbers of postgraduate students in this scenario because it would require too much relevant effort of our public budget. For this reason we propose—although with some regret—to concentrate our effort in specific areas, aiming at obtaining results in the short term that are useful for the health of our increasingly older population. First, we should concentrate on setting a number of high-standard research centers dedicated to improve the quality of care from both medical and structural points of view. Obviously, these centers need to be closely linked with hospitals, postacute and rehabilitative settings, nursing homes, and home care services to implement the programs generated by the research. Second, strictly connected with those centers, high-quality teaching programs are needed to influence the education and training of all young physicians (and other professionals) independently from their particular sector of medical interest.
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