What factors are contributing to - or are expected to contribute to - the shortage of geriatricians?

Over the last 5 years, a declining number of US medical school graduates have been choosing careers in internal medicine and family medicine — the two fields that are the source of applicants for geriatric fellowship programs. Physicians in internal medicine, family medicine — and geriatrics — earn significantly less and have less predictable work schedules than those in other medical and surgical specialties, especially popular disciplines such as dermatology, plastic surgery, otolaryngology, radiation oncology, and emergency medicine.

A career focused on caring for older adults can be particularly financially unattractive for physicians with increasingly large medical school loan debts. Physicians graduating from U.S. medical schools in 2010 owed an average of $158,996 for their education. Thirty-nine percent of these graduates said that salary expectations were a moderate or strong influence in determining their specialty.

In many parts of the U.S., Medicare payment rates for physicians are lower than commercial insurance rates. Medicare reimbursement rates for mental health services are discounted even further than rates for geriatric medical services. Medicare reimbursement is the major source of income for most geriatricians and, as a result, community-based geriatricians have lower incomes than most other physician specialists.