William R. Hazzard, MD
Hazzard WR. The Department of Internal Medicine: Hub of the Academic Health Center Response to the Aging Imperative. Ann Intern Med. 2000;133:293-296. doi: 10.7326/0003-4819-133-4-200008150-00014
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Published: Ann Intern Med. 2000;133(4):293-296.
In the 21st century, geriatrics will increasingly dominate U.S. health care as the median age of the population progressively increases. Academic departments of geriatrics have been created in nations that have already experienced this shift. As an alternative strategy that builds on traditional strengths of academic medicine in the United States, departments of internal medicine should lead a multidepartmental, pan-institutional response to the aging imperative. Recognition of gerontology and geriatric medicine as central to the missions of internal medicine in clinical care, education, and research must be increased. In the process, academic departments of internal medicine will develop a high level of geriatric expertise and will launch many programs that address this challenge. Successful development of geriatric programs will serve as a catalyst to strengthen the integration among and between generalists and subspecialists. This will entail developing optimal sites and systems of geriatric care—at different levels of care and over time—that can enhance the geriatric education of medical students, residents, fellows, and practicing physicians. The study of aging and geriatric health care will also become an integral part of departmental research, in its subspecialty divisions as well as its divisions of general internal medicine and geriatrics. This strategy is urgently recommended as both a challenge and an opportunity for all departments of internal medicine.
This comprehensive program of excellence in gerontology and geriatrics shows the many interrelationships among disciplines and academic units. The character of geriatrics as a “supraspecialty” can be appreciated, and the central role of internal medicine as its departmental anchor is apparent.
From Veterans Affairs Puget Sound Health Care System, Seattle, Washington.
Grant Support: By the John A. Hartford Foundation to the American Geriatrics Society (#94269-G).
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