Study charts decline in geriatric medicine certification among family physicians

By Jill Pease

Dr. Ara Jo
Dr. Ara Jo

Despite increasing health care demands from a large aging population, the number of family physicians who have received and maintained certification in geriatric medicine dropped significantly between 1988 and 2019, a new University of Florida College of Public Health and Health Professions study finds. The findings appear in the journal Family Medicine.

A certificate of added qualifications in geriatric medicine is offered by the American Board of Family Medicine in conjunction with the American Board of Internal Medicine. Geriatric certification allows family physicians to demonstrate excellence in care for older patients, such as providing comprehensive geriatric assessment and management for patients, their families and other caregivers, said the study’s lead author Ara Jo, Ph.D., a clinical assistant professor in the PHHP department of health services research, management and policy.

“This professional opportunity gives physicians the knowledge necessary to develop prioritized management plans for their older adult patients and deliver patient-centered care with an in-depth understanding of multiple aspects of their patients’ health as their primary care provider,” Jo said.

The number of Americans age 65 and older is expected to reach 73 million by 2030, with nearly half vulnerable to high rates of frailty, decreased physical function and complex comorbidities that can occur with cognitive impairment, the authors write. Previous research has shown that patients who are treated by geriatricians have lower rates of 30-day hospital readmissions, better detection of health conditions common among older adults, better quality of life and improved rates of appropriate medication use. Yet, only about 4% of patients 65 and older are currently under a geriatrician’s care.

The UF study used American Board of Family Medicine administrative data to examine trends in geriatric care certification and characteristics of physicians who obtained certification. Researchers found that family physicians who are certified in geriatric medicine were more likely to be male, White and practice in urban rather than rural locations. A change in eligibility requirements for certification in 1994 led to a precipitous drop in the number of physicians obtaining the certification, with only a small rebound over the next 25 years.

Other factors may also contribute to the overall decline, Jo said, including less interest in geriatric medicine among medical students, more resources required for geriatric care, and the need for the certificate to be renewed.

“Currently, there is little financial support for additional training and fellowship in geriatric medicine for medical students,” she said. “With the demand for geriatricians increasing, it is critical that we provide more financial incentives for providers who meet quality care indicators in geriatric medicine.”

Study co-authors included Mingliang Dai, Ph.D., and Lars Peterson, Ph.D., of the American Board of Family Medicine; and Arch Mainous III, Ph.D., of the University of Florida.