Hawaii Faces ‘Critical’ Shortage of Geriatricians

Hawaii, where residents have the longest life expectancy in the nation, faces a "critical" shortage of geriatricians, the Pacific Business News reports. Although Hawaii has about 35 licensed geriatricians, "few choose to go into private practice," and many move into salaried positions, according to Patricia Blanchette, chair of the Department of Geriatric Medicine at the University of Hawaii's John A. Burns School of Medicine. Many geriatricians also decide to practice in other states, the Business News reports. "There is clearly a large unmet need because families and patients are demanding to see a geriatric specialist. They start trying to find somebody and they can't," Blanchette said. For example, UH's geriatric medicine program at Kuakini Medical Center has a three-month waiting list for geriatricians who provide outpatient care, she said. According to Dr. Curtis Takemoto-Gentile, a private practice geriatrician in Hawaii, geriatricians require more time to assess the multiple problems common in elderly patients, such as dementia and Alzheimer's disease, and as a result, they visit fewer patients than other specialists and receive less in reimbursements from Medicare. For example, Medicare reimburses geriatricians $60 for a two-hour patient visit, compared to $350 for a specialist who visits 10 patients in two hours, he said. In addition, geriatricians do not receive reimbursements for tests or surgeries and are paid more than 40% less than other specialists, Takemoto-Gentile said (Sawada, Pacific Business News, 8/2).