I am writing this, my last column, just after President Obama delivered the State of the Union address—so it is not surprising that I am inspired to share my thoughts with you about the “State of the American Geriatrics Society” during my memorable year as its president. I am delighted to report that we have never been better.

We made remarkable progress in 2010, including seeing provisions included in the health care reform bill that support our field and the older adults about whom we care so deeply. It was a historic moment when the President signed the Affordable Care Act—one for which many of us had worked intensively for years. Although there are challenges to the law on several fronts, we are directing our comments to the Centers for Medicare on the regulations that will implement the primary care bonus, which will benefit our field, establish the Innovations Center that will test promising new models of care (many of which we have championed), and establish the Independence at Home demonstration project, which the American Association of Home Care Physicians has long supported.

As a result of our advocacy efforts, the Affordable Care Act includes enhancements to geriatrics education programs under Title VII and Title VIII. Though we have much to be proud of, it is clear that we still need to work tirelessly to advocate for provisions that are good for seniors and for the geriatric health professionals who care for them. We can never rest on our laurels.

Another event worth special mention was the release of the AGS’ and British Geriatrics Society’s updated guideline on preventing falls, which are one of the most common and debilitating problems that older adults experience. The summary guideline was published in the Journal of the American Geriatrics Society (Vol. 59, Issue 1, pp 148-157, Jan. 2011), and drew widespread media attention because we focused on how preventing falls can be a matter of implementing a few relatively simple interventions, such as an exercise program like Tai Chi, wearing safe footwear, and reducing medications. This is the kind of “less-is-more” medicine that is the very foundation of our specialty.

Our members have also had a busy and productive year. They have collaborated on extensive comments to CMS and other organizations on topics ranging from physician payment policy, to quality measures for nursing homes, to inclusion of geriatrics principles in graduate medical education. Many of our members now serve on bodies that will have a significant and substantial impact on geriatrics policy. Two of our AGS members who are serving in these national leadership roles include:

Mary Tinetti, MD: In January 2011, the US Government Accountability Office (GAO) appointed Mary to the Methodology Committee of the Patient Centered Outcomes Research Institute (PCORI). In her role, Mary will help develop methodological standards and guidance for comparative clinical effectiveness research. Her committee will help patients, caregivers, clinicians, and policymakers understand how to prevent, diagnose, treat, and monitor multiple diseases and health conditions.

Jerry C. Johnson, MD: Serves as Co-Chair of the Dementia Measure Development Work Group established by Physician Consortium for Performance Improvement (PCPI) of the American Medical Association. This group is charged with developing a new set of evidence-based quality measures for dementia that address such areas as end-of-life issues related to dementia care, staging of dementia, and counseling related to safety issues and driving risks.

Also in 2010, AGS worked to change the Drug Enforcement Agency implementation of the Controlled Substance Act in nursing homes. We recognize how difficult this interpretation has made it for our members to ensure that older adults residing in nursing homes are pain free. Early in 2010, then AGS President Cheryl Phillips, MD testified before the Senate’s Special Committee on Aging. Cheryl told the Committee, “I am here because every day, across the country, the real-life consequence of the Drug Enforcement Administration (DEA) interpretation of the Controlled Substance Act is that, collectively, we are preventing patients in long-term care settings from receiving much needed pain relief and other medications in a timely manner. We can, and should, be doing better.” I am pleased to report that the DEA will be working with Senate Aging on a legislative proposal that will change how the act is interpreted when it comes to nursing home care. That change in position is due to our—and your—tireless advocacy on behalf of older adults.

The Association for Directors of Geriatric Academic Programs (ADGAP) also had a dynamic 2010. Established in 1990, ADGAP leadership and members are undertaking a dynamic initiative to ensure that they are actively meeting the needs of academic program directors across the country. AGS and ADGAP are also examining ways to cohesively address the issues that are so critical to all academic physicians. In January 2011, with funding support from the John A. Hartford Foundation, the program directors gathered in San Diego for the ADGAP leadership retreat. A large part of the retreat was devoted to the identification of collective action items that ADGAP members can incorporate into a plan to advance academic geriatrics.

January 2011 marks the moment when the first wave of baby boomers reaches the age of 65. This silver tsunami has significant implications for our nation and its health care resources. In 2008, the Institute of Medicine called for the nation to focus on enhancing the capacity of the entire workforce to care for the growing number of older adults. AGS has long worked to ensure that all health care professionals are competent to care for older adults. We lead coalitions such as the Partnership for Health in Aging and the Eldercare Workforce Alliance, which strengthens our impact across many disciplines. In May 2010, the Partnership for Health in Aging released multidisciplinary geriatrics competencies for older adults that have been endorsed by a wide range of organizations. Our Chief Operating Officer, Nancy Lundebjerg, co-convenes the Eldercare Workforce Alliance, which has been very effective in its advocacy regarding inclusion of geriatrics workforce provisions in health reform legislation.

I am pleased to report that in 2010, we began Phase V of our longstanding Geriatrics-for-Specialists Initiative with a renewal grant from the John A. Hartford Foundation. Under this initiative, we have been working for several years to increase surgical and related medical specialists’ competency to care for older adults. With funding from Hartford, and the Atlantic Philanthropies, we have supported 79 Jahnigen Scholars who are conducting research on the aging aspects of their specialty. We’ve also funded development of curriculum materials that are now used in specialty resident education at a number of institutions.

In late 2010, the National Institute on Aging issued a request for proposals for the GEMSSTAR program (Grants for Early Medical and Surgical Subspecialists’ Transitions to Aging Research) with the goal of providing critical research support to physician-scientists pursuing a research program focused on the geriatric population. Generous funding from the Hartford Foundation and matching funding from specialty organizations has allowed us to offer career development awards to GEMSSTAR recipients in our ten targeted specialties.

Another highlight of this year has been the appointment of Jennie Chin Hansen as our CEO. Jennie began working with us at the same time that I became President, and it has been wonderful working together during her first year. Jennie has crisscrossed the country to further our organization’s mission, and has had the opportunity to positively impact geriatrics and the AGS in many venues. She met with the new head of CMS, Donald Berwick, MD and also with key CMS staff charged with implementation of the Office of Coordinated Care (also known as the Office of the Dual Eligibles) and the Innovation Center. Jennie also represented the AGS as she keynoted several meetings emphasizing both workforce and policy matters germane to our field. Now in her final year as a MedPAC commissioner, Jennie continues to articulate the need for Medicare payment policies that support high-quality, safe care for older adults.

We are delighted that she has been asked to now serve as a member of the board of the Institute for Healthcare Improvement, and has been a member of the committee working on the matter of GME with the Josiah Macy Foundation and the Association of Academic Health Centers.

In her address to the Gerontological Advanced Practice Nurses Association (GAPNA), Jennie said: “Our job is to help harmonize for the greater good. As the number of older Americans increases, the need for multi-disciplinary teams will increase, especially as many of our elders cope with multiple chronic conditions. We’ll need professionals with special geriatrics training in all disciplines working together to care for our most complex, frail elders.”

Finally, I am looking forward to our 2011 Annual Scientific Meeting (May 11 to 14 at the Gaylord National Harbor in suburban Washington, DC). During the meeting, my friend and colleague Barbara Resnick, PhD, CRNP, will become AGS president. I am very proud that in just over a decade, we have successfully expanded AGS into a home for professionals from a variety of disciplines. Barb will be our first nurse to serve as AGS president, and brings broad experience as a practitioner, researcher, and academician. I know you will join with me in welcoming her to her new position in the AGS.

I am honored to have had the privilege to serve as your president, and I want to take this opportunity to thank all of my fellow AGS members for your encouragement and support during this past year. I would also like to thank the AGS staff, who work so hard on our behalf. Our organization is in very good hands.

Sharon Brangman, MD