Guest columnist: A call for all physicians to care for older adults
Published 12:00 am Thursday, February 12, 2026
We know our heart is not designed to beat outside, but when we are in crisis, our mother’s heart, bared, beats for us forever from outside, even as she turns to our grandmother. Are we caring for them? A crisis of quiet neglect is continuing in Kentucky and across America. It is, obviously, the health care of all older adults.
According to the 2022 Kentucky Physician Report, about 10,002 doctors practice in Kentucky for a population of 4.5 million. However, only 48 of them serve about 780,000 older adults, who are certified geriatricians (doctors who can exclusively care for and treat elderly adults).
According to 2023 data, America has 332 million people to care for, including 60 million aged 65 and older. But only 7,123 certified MD geriatricians and 331 osteopathic DO geriatricians are available, according to the American Geriatrics Society (AGS). It means one geriatric Doctor for every 8,000 people.
For decades, health administrators knew that adults were aging rapidly and living longer, yet the shortage of geriatricians was shrinking. For example, in Kentucky alone, 55 geriatricians served in 2017, and that number reduced to 48 in 2021. It is expected that we will face a shortage of 30,000 geriatric doctors in 10 years, and we cannot meet the demand as the adult population increases to 42.4% by 2034, according to the Association of American Medical Colleges (AAMC).
Currently, we are maintaining the status quo by assuming that the available Family or Primary doctors will take care of all our older adults. We can blame it on a systemic failure and move on, but we need to recognize the causes that stall progress in older adult health care in America.
Though we produce 1000s of MDs, we face a shortage of geriatricians. It is because, as reported by AGS, the required or elective geriatrics training in US medical schools is declining, for example, decreasing to 10 % in 2021 from 23% in 2005. After obtaining Residency, several fellowship positions that help an MD specialize in a practice field remain unfilled. According to the National Resident Matching Program, only 151 out of 388 positions filled geriatrics fellowships. Even after completing geriatrics fellowship training, several young physicians are deterred by lower Medicare reimbursement rates than those for private insurance. Some medical facilities prioritize high-tech cure options over managing older adults who seek cost-effective treatments for chronic conditions.
Half a century ago, America had “House Call Doctors” in every town to care for elderly patients beyond the hospital walls. It provided more real-time assessment of the risks an adult patient faces in their own home, such as slippery bathrooms, an unhealthy bed, loose rugs, or poor eating habits. But due to legal issues, time constraints, insurance profitability, and reimbursement chaos, the Doctor’s home visit had become outdated. Revisiting this option once again may help our senior citizens.
Unlike pediatric training, accountability in geriatrics training lagged for a long time. The first publication on a set of “Consensus Geriatrics Competencies” came out only in 2009 and was revised in 2025. Since then, some educators have introduced a new geriatrics curriculum. All our medical schools must take advantage of this opportunity and make geriatrics a mandatory, core component of medical education, with an overhaul from top to bottom, by focusing on the care of older adults as its honorable primary mission.
The Federal policies to be created for embedding geriatric curriculum as a priority and part of every medical student’s education and resident’s training, regardless of specialty. State legislators ensure that all doctors have that competency in the ‘older adults health program’ to practice in the state. As individuals, we are committed to preventing harm to older adults. As employees, it is our duty to improve our health outcomes. As insurers, it is our burden to lower their overall health care costs. As medical care providers, it is our obligation to adopt evidence-based models and practices that deliver better care to our rapidly aging population across all settings, including the home and community.
There is no doubt that we are making progress in the care of older adults compared to a few decades ago. Our policymakers know that 18% of the US population is senior citizens (over 65), and they allocate 37% of their health care spending exclusively to their well-being. The National Board of Medical Examiners, which develops Shelf and Licensing examinations for medical students, has now included 5-10% of geriatric questions in Step 1, 2, and 3 Exams. Several hospitals are stepping up their treatments to care for older adults. Some are redesigning ERs, spurred by specialized initiatives such as Geriatric Emergency Departments, to educate new trainees and longstanding employees in their capacity, now more than ever before. The John A. Hartford Foundation ( and the Institute for Healthcare Improvement ( are examples.
Until we have enough geriatricians, the best option is to mandate that every Doctor be equipped with fundamental geriatric competencies and be able to treat older adults. It includes universal standards such as patients’ specific health goals, proactively screening for dementia, depression, and delirium, and ensuring elderly patients prevent the epidemic of immobility.
Aging is neither loss of youth nor a disease, but it is an accumulation of wisdom, experience, and love. By creating the possibility for every Doctor to serve older adults, we can reduce societal costs, celebrate their lives, improve their dignity, strengthen their personalities, and preserve family continuity.
Narayanan Rajendran, Ph.D., is a professor of biology at Kentucky State University. He can be reached at [email protected].
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