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The Futures Program: A Solution to the Physician Shortage in Geriatrics and Long-Term Care

      Today’s digital and print geriatrics news are citing, almost daily, the overall workforce shortage being experienced in the United States. When we look specifically at health care, it reflects what is occurring in the general workforce. Within health care, I want to focus specifically on physicians. There are limited studies on the physician workforce; however, there are many projections of physician shortages, based on forecasting models, by 2030. In terms of geriatrics physicians, the numbers are staggeringly high.
      In 2006 the baby boomer generation started turning 60, and by 2030 this population will have grown from 36.8 million to 70 million when all boomers will have reached the age of 65. The American Geriatrics Society anticipates that 36,000 geriatricians will be needed by 2030. Currently, there are approximately 7,600 practicing in the United States. We are a short nine years from experiencing a geriatric “perfect storm.”
      As the physician shortage continues, the data reflect the ongoing trend to fill the gap with advanced practice practitioners. An article published by the American Association of Nurse Practitioners in 2019 (https://bit.ly/2UH0rW2) found that “by 2026, the Bureau of Labor Statistics projects that the NP role will have grown by 36 percent compared to 13 percent for physicians excluding anesthesiologists and surgeons.” Although there is a lack of nursing-home–specific data, Medicare billing data demonstrate the continued growth of the number of advanced practitioners in nursing home settings.
      The physician shortage is something that the Society, in partnership with its Foundation, has been focused on since 2001.
      Fortunately, this shortage is something that AMDA – The Society for Post-Acute and Long-Term Care Medicine, in partnership with the Society’s Foundation, has been focused on since 2001, when the Futures Program was created. One of the program’s primary goals is to introduce residents and geriatrics fellows to long-term care settings and inform them about the many practice opportunities in these settings, including the role of the medical director.
      This year the Futures Program is celebrating its 20th anniversary, and the Foundation is proud to report that:
      • Approximately 1,250 people have participated in the Futures Program.
      • 20% of the participants have received their Certified Medical Director (CMD) designation.
      • 25% of the participants have taken the Core Curriculum.
      Many Futures participants have served as committee chairs, board members, and national leaders in PALTC.
      When you consider the future in senior care, I think of the words of Bill Gates in his book The Road Ahead (Viking Penguin, 1995): “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten.” The next 10 years in health care will be pivotal as the older population expands and the labor force shrinks. Those of us serving on the Foundation board view this as an opportunity.
      The vision of the Foundation board is to expand the Futures Program and ensure that all interested physicians and advanced practitioners have expertise in caring for older adults in the PALTC environment. Further, especially considering the physician shortage, we plan to continue expanding and tailoring the program to include more interdisciplinary participants such as nurse practitioners, physician assistants, social workers, and PharmD graduates.
      Curriculum enhancements are also being considered to reflect many of the changes experienced in long-term care due to the COVID-19 pandemic. The Foundation’s goal is to support the education, through funding, of practitioners interested in long-term care so that they better understand the uniqueness and opportunities available within the PALTC spectrum.
      In preparation for the changes occurring during the next 10 years, please consider joining the Foundation’s work and helping to support the enhancement of the Futures Program. Visit https://www.paltcfoundation.org/ if you are interested in contributing to the Futures Program.
      Ms. Wassenaar is the owner of Wassenaar Consulting, LLC, and a member of the Foundation’s Board of Directors.