Clinical Geriatrics

The American Geriatrics Society Board of Directors recently adopted a strategic plan that will guide the AGS for the next three years. Under the plan—the work of the AGS Strategic Planning Task Force—the AGS will undertake a number of key projects to improve the quality of health care for older adults and promote geriatrics as a discipline for all health care professionals. These projects, which offer clinicians numerous opportunities to play roles in shaping the future of health care for older adults, involve:

• Reforming payment policy
• Developing materials to help patients and their families understand the elements of quality geriatric care and how to obtain such care
• Defining core competencies for health care professionals caring for older adults
• Establishing requirements to ensure competence in the care of older adults in a greater number of health care profession training programs
• Creating comprehensive leadership education programs for geriatrics health care professionals
• Developing and proposing mechanisms for loan forgiveness for physicians and other health care professionals entering geriatrics
• Developing and articulating clear messages about, and advocating for, geriatric research
• Developing, promoting, and disseminating a “recruitment toolkit” to attract promising candidates to geriatrics disciplines

Within the next couple of months, the AGS plans to appoint volunteers to interdisciplinary committees and advisory groups that will bring these projects to fruition. While the Task Force drafted brief working descriptions of each of the projects, the consensus of Task Force members was that individual committees and groups would come up with detailed plans for their implementation. The AGS is now actively recruiting volunteers. If you’re interested in advancing any of the above projects, here’s your chance. (More on how to get involved, below.)

I’d like to devote the rest of this column to two of the projects: developing materials to help patients and their families understand the elements of quality care for older adults and how to obtain such care, and reforming payment policy, because both are of particular interest to those of us in clinical practice.

One of the challenges we continue to face in the field is the widespread lack of familiarity with what constitutes quality care for older adults. A surprising number of people simply don’t know that some health care professionals—physicians, nurses, and clinical social workers, among others—are specially trained to meet the unique needs of older adults. As a result, many don’t understand why the growing shortage of such practitioners is a serious problem. We need to address this, and developing brochures and other materials for patients and families can help us go a long way in this endeavor. It will also, of course, help patients and their families find appropriate care.

As the Task Force conceives of it, developing these materials would entail creating guides covering each setting or phase of care (eg, primary care providers’ offices, nursing homes, hospitals, end-of-life care facilities). The details haven’t been worked out yet, and your input is welcome. Again, this is a key opportunity for those of us in clinical practice to help the public understand what we do and get the health care they need.

We clinicians can also play an important part in efforts to reform payment policy. Congress, the Centers for Medicare & Medicaid Services, and other players have already proposed or are at work on legislation and regulations that could affect payment dramatically. Sens. Chuck Grassley (R-IA) and Max Baucus (D-MT), for example, recently proposed pay-for-performance legislation, as did Rep. Nancy Johnson (R-CT). The right legislation would not only make Geriatrics a more viable and attractive field, it could also encourage all health care professionals to provide high-quality care for older adults.