Like many other doctors across the country, Dr. Jerry Haag has seen the average age of his patients increase as the nation’s population grows older.
When Haag, medical director of South Jersey Healthcare LIFE in Vineland, started practicing in 1977, at least half of his time was spent caring for seniors. Over the past 15 to 20 years, at least 75 percent of his patients have been in the geriatric age group of 75 and older.
One reason Haag has seen this is because of a shortage of geriatricians, doctors trained specifically for dealing with the aging. Only 17 doctors who specialize in geriatric medicine are spread out among Atlantic, Cape May, Cumberland and southern Ocean counties.
Haag’s $3.4 million Living Independently For Elders (LIFE) center, which opened last year, is a place where qualified senior citizens can receive a variety of services in one location at no cost. Doctors, nurses and other health care professionals provide treatment and monitor changes in a client’s health.
“They realize that time is running out for them, so, unless they are depressed or very despondent, they fight for every precious moment left to them. They are feisty, but responsible; hardy, but vulnerable, and hate every minute of getting old,” said Haag, 66, a family medicine specialist.
With their special training, geriatricians bring an understanding of what life is like for older patients. This guides physicians’ medical treatments in ways other doctors might not think of.
“If an older adult has to be on a water pill because they had heart failure, that person will have to urinate frequently. It will be hard to leave the house if you are on a medication like that. So you (the doctor) might consider what time of day you give that medication,” said Dr. Sharon A. Levine, a geriatrician at Boston Medical Center and professor of medicine at Boston University School of Medicine. “If you give it at night, somebody may be up all night. You might increase their chance of falling on the way to the bathroom.”
By 2030, 70 million Americans will be 65 or older — but there are currently only 7,200 board-certified geriatricians in the U.S., Levine said.
Based on population projections, it is estimated about 30,000 geriatricians will be needed by 2030.
The way geriatric fellowships are being filled, there is no way the country can actually get to that number, said Dr. Anita Chopra, director of the New Jersey Institute for Successful Aging in Stratford, Camden County.
Steps are being taken to attract more doctors toward geriatric medicine. In recent years, requirements for a geriatrician fellowship have been reduced from two years to one, Chopra said.
But besides the extra year of schooling, it is a very labor-intensive specialty, in which a doctor needs to spend time with the patients and their families — and the financial reimbursement for the work isn’t that good, Chopra said.
“The way our health system works, you get paid more money for doing procedures rather than spending time with patients and families and coordinating care. Once they get out (of medical school), they will not be making as much money. A lot of medical students, when they come out of medical school, they have a lot of debt,” Chopra said.
As a way to compensate for the lack of geriatricians, there are continuing-education courses, workshops and online instruction available to help doctors of all specialties learn more about treating seniors, Levine said.
More medical schools also are introducing geriatrics into their curriculum, Levine said.
“Anybody who is going to come in contact with older adults in the health care system has to know something about the special circumstances that older adults face,” Levine said.
Chopra agreed doctors such as Haag provide most of the care.
“At the institute, we are trying to form a relationship with our primary care physicians, working collaboratively with them, because most of the care of the older patients is going to be provided by primary care doctors, whether it’s family doctors, or doctors who are trained in family medicine, or doctors who are trained in internal medicine,” she said.
Joe Caserta, 90, of Ocean City, is pleased with the treatment he receives from Dr. Brian F. Gery, even if the doctor’s specialty is internal medicine. Caserta’s wife of 64 years, Eileen, started seeing Gery, who is based in Somers Point, first. Based on her recommendation, Caserta has been seeing Gery for the past five years.
“He knows his business. He’s very easy to talk to. He takes his time. He doesn’t rush you. He listens, and he explains really well,” said Caserta, who added that he and his wife see Gery multiple times during the year.
Two-thirds of most primary care practices serve people 65 and older, estimates Dr. Peter Jungblut, a member of the Shore Physicians Group, which is affiliated with Shore Medical Center.
The percentages drop as the age rises. Twenty-five percent of a practice’s patients may be those 75 and older, and 20 percent of a practice could be those 80 and older, said Jungblut, who also has an office in Somers Point.
“It’s different. It’s very rewarding,” he said. “They have seen a lot. They’ve been through a lot. They usually have great stories to tell. They are usually very enthusiastic when talking about their families. ... In general, it’s really a lot of fun to be working with them to help them maintain a rewarding quality of life and keep active and independent.”
Contact Vincent Jackson: