[Congressional Record Volume 151, Number 87 (Monday, June 27, 2005)]
[Extensions of Remarks]
[Page E1369]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          HON. ROSA L. DeLAURO

                             of connecticut

                    in the house of representatives

                         Monday, June 27, 2005

  Ms. DeLAURO. Mr. Speaker, as our nation's 76 million baby boomers 
near retirement age, the number of Americans over age 65 will double to 
70 million--one-fifth of the population. Americans older than 85 
represent the fastest growing segment of this population and membership 
in this once exclusive demographic group is projected to grow from four 
million Americans today to an estimated 19 million by 2050.
  Unfortunately, our health care system is ill prepared to handle the 
strain of this enormous senior population, largely because we have a 
critical shortage of geriatric physicians. Fewer than 9,000 
geriatricians practice in the United States, less than half of the 
current need. By 2030, the shortfall of geriatricians may reach 25,000 
doctors. Approximately, 2,500 psychiatrists have received added 
qualifications in geriatric psychiatry; yet 4,000 to 5,000 geriatric 
psychiatrists are needed to provide patient care.
  According to estimates from the President's Commission on Mental 
Health, at the current rate of approximately 80 new geriatric 
psychiatrists graduating each year and an estimated 3 percent 
attrition, there will be approximately 2,640 geriatric psychiatrists by 
the year 2030, or one per 5,682 older adults with a psychiatric 
  America must plan for the burdens the baby boomers demographic shift 
will place on our health care system and health care providers. Our 
first step is ensuring the country has an adequate number of well-
trained physicians who specialize in geriatrics.
  Today, I am introducing legislation along with my colleague 
Congresswoman Ileana Ros-Lehtinen of Florida, that will encourage more 
doctors to become certified in geriatrics. The Geriatricians Loan 
Forgiveness Act would amend the Public Health Service Act to include 
each year of fellowship training in geriatric medicine or geriatric 
psychiatry as a year of obligated service under the National Health 
Corps Loan Repayment Program. Specifically it would forgive $35,000 of 
education debt incurred by medical students for each year of advanced 
training required to obtain a certificate of added qualifications in 
geriatric medicine or psychiatry.
  Geriatric medicine is the foundation of a comprehensive health plan 
for our most vulnerable seniors. Geriatrics, by focusing on assessment 
and care coordination, promotes preventive care and improves patients' 
quality of life by allowing them greater independence and eliminating 
unnecessary and costly trips to the hospital or institutions. A 
fellowship in geriatric psychiatry provides intensive training in the 
biological and psychological aspects of normal aging, the psychiatric 
impact of acute and chronic physical illness, and the biological and 
psycho-social aspects of the pathology of primary psychiatric 
disturbances of older age. Thus, these specialists are equipped to 
diagnose and treat these complex conditions among our frailest 
  Mr. Speaker, this kind of specialized care is complicated and 
demanding. Many doctors inclined to study and practice geriatrics are 
dissuaded from doing so because treating the elderly takes more time 
and carries financial disincentives for doctors.
  Medical training takes time, and it is important that we take steps 
now to alleviate the shortages in geriatrics that are only going to get 
worse in the next ten years and beyond. This legislation is a 
commonsense approach and a cost-effective investment, and I hope it 
will receive the support of the House.