Geriatricians specialize in caring for the often-complex health problems of the elderly, but in New Jersey and the U.S. there should be more of these specialists, according to the American Geriatrics Society.

The society estimates New Jersey should have 508 geriatricians but had only 296 in 2011. In the U.S., there are about 7,000, but the need exists for more than 17,000, the society says.

Dr. Cathy Alessi, president of the American Geriatric Society, says the shortage of doctors coming into the specialty is primarily a product of reimbursement rates paid by Medicare, the federal insurance program for those aged 65 and older.

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"Many medical students graduate with significant debt and unfortunately geriatrics has not been viewed as a field where reimbursement is high," Alessi said.

This matters at a time when the region and the country are getting older.

U.S. Census data shows the number of residents of Atlantic, Cape May, Cumberland and Ocean counties aged 85 and older grew 11 percent between 2006 to 2011, compared to 3 percent overall population growth during that time.

Nationally, this segment of the population is expected to reach 19 million by 2050, or nearly quadruple what it is today, the Census Bureau estimated.

For physicians, a geriatric medicine certification requires a year of additional training after family medicine or internal medicine certification, Alessi said.

"Geriatricians are experts in the handling of conditions and diseases which are common in older adults, and they're experts in understanding the full assessment and management of the full individual in addition to the health problems, which can be very complex," she said.

Dr. Mitchell Kaminski, medical director of AtlantiCare Physician Group Primary Care and Medical Specialties, said much of primary care and internal care training focuses on geriatric care.

AtlantiCare has several board-certified geriatricians, but Kaminski said the national trends mean many of those older than 65 will be treated by primary care physicians.

"The reality is the bulk of care we will all receive as we age will be in the form of primary care physicians rather than geriatric-boarded physicians," he said. "I think it's unrealistic to think we can all expect to go to geriatricians as we reach 65 and older. Patients should be reassured that for primary care providers, a lot of their training involves caring for geriatric patients, and they can get good care from primary care as they age."

AtlantiCare Physician Group Primary Care Plus has 31 total physicians, all with board certifications and two of whom are currently certified in geriatric care, AtlantiCare said. Another did a fellowship in geriatric care and recently sat for her boards, AtlantiCare said.

AtlantiCare Regional Medical Center's staff has another physician board certified in geriatric care.

The American Board of Medical Specialties lists fewer than a dozen certified, active physicians of geriatric medicine with their most current addresses in Atlantic, Cape May or Cumberland counties.

On its website, the American Geriatrics Society says inadequate Medicare reimbursements for geriatric services are a major disincentive for those who would begin or continue a career in geriatrics.

Alessi said the specialty is highly rewarding - in both dealing with the patients and challenge of complexity of their medical issues. She hopes this can hopefully draw more doctors and students into the field.

"We also need to paint a better story to draw people to our field and make sure that students are trained and aware of what a wonderful job this year," she said.

"I was drawn to geriatrics because I really like older people, and I had a wonderful relationship with my grandparents," she said. "It's truly a compelling desire and interesting working with older people."

"I'm optimistic that we're going to be able to tackle this problem and on my side as a professional we need to keep up the good fight. I think that patients are going to demand it as the population gets older," she said.

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