A recent article in the Lancet, a leading UK medical journal, has highlighted the fact that the elderly with multiple health problems do better when treated by teams led by geriatricians. However, the number of geriatricians remains critically low. Currently there are just 7000 in the USA. The American Geriatrics Society has warned that the aging US population faces a critical shortage of geriatricians. But why is this?

A hundred years ago, one person in 20 worldwide was aged 65; today it is one in six. It is estimated that by 2030 there will be 70 million Americans over the age of 65. Between 2010 and 2030 one in five Americans will be over 65. In the West we are all living longer and despite the advances in medicine many will experience age-related health problems.

Geriatrics has always been viewed as a specialism lacking glamour - a Cinderella service. When did any of us last see a TV series promoting the lead role of geriontologist? There's no avoiding the fact that old age is just not cool. Getting to a ripe old age is something most people would like, even if its something they don't exactly aspire to, but the process of aging is something Western society is trying increasingly to avoid. Sixty may be the new middle age, but it appears to be increasingly bolstered by creams, botox and cosmetic surgery.

I guess (I hope) the situation and the general attitude towards old age will have to change. With so many of us reaching very old age and demanding more from our health services the market needs to respond. Some business types have already seen the potential and there is something of a growth in the way of elderly support services and private residential accommodation, but these services often fall short when it comes to medical or nursing care. The Lancet blames current poor recruitment of geriatricians on geriatricians themselves. They say they are failing to take a strong leadership role and not giving an "audible voice" about their work.

Geriatricians have to start promoting the opportunities in education, research, in collaboration and in advocacy. They must also include elderly care in undergraduate and postgraduate training programmes to promote a compassionate and competent service to old people.

How do Geriatricians make a Difference?

Specialists are people who are at the top of their game in terms of their knowledge, skills, and their approach to looking after their patients. Geriatricians are often part of a team of other health professionals that also specialize in care of the elderly. The elderly, by the way, are still defined as those 65 years of age or over. A team of health professionals will include nurses, social workers, occupational therapists, dietitians, physiotherapists, pharmacists and a geropsychiatrist. With their expertise they adopt an holistic approach to care, treatment and rehabilitation of their patients. The medical history and current illness or condition is evaluated and treatment plans are put in place accordingly.