Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 28
Geriatrics in the United States
ОглавлениеThe development of modern geriatrics is strongly based on the Veterans Administration and private foundations, such as the Josiah Macy Jr Foundation, the John A. Hartford Foundation, and the Donald W. Reynold Foundation. The Veterans Administration developed the Geriatric Research, Education, and Clinical Center in 1976. These institutions have been the leaders in developing geriatric faculty, science, and education at major universities in the US. They also played a leadership role in developing palliative care and the teaching nursing home concept. In 1940, the Unit of Aging was started by the National Institutes of Health. In 1958, under the leadership of Nathan Shock and Reuben Andres, this became the Baltimore Longitudinal Study of Aging. The National Institute on Aging was established in 1974. Robert Butler was its first director.
There are three major geriatrics and gerontological societies in the US. Each sponsors a yearly meeting and has its own journal. The Club for Research in Aging was founded in 1939, and it evolved into the Gerontological Society of America in 1945. The Journal of Gerontology was first published the following year. The Joseph T. Freeman Award was first given in 1980 to Robert Butler, and its awardees read like a modern Who’s Who in American Geriatrics (Table 1).
Table 1 The Joseph T. Freeman Award of the Medical Sciences Section of The Gerontological Society of America.
| Year | Recipient |
|---|---|
| 1980 | Robert N. Butler |
| 1981 | Isadore Rossman |
| 1982 | Manuel Rodstein |
| 1983 | R. Knight Steel |
| 1984 | Joseph T. Freeman |
| 1985 | T. Franklin Williams |
| 1986 | Charles M. Gaitz |
| 1987 | John W. Rowe |
| 1988 | Eric A. Pfeiffer |
| 1989 | Saul Kamen |
| 1990 | John C. Beck |
| 1991 | Evan Calkins |
| 1992 | Christine K. Cassel |
| 1993 | Reubin Andres |
| 1994 | Steven R. Gambert |
| 1995 | Richard W. Besdine |
| 1996 | Lissy jarvik |
| 1997 | David H. Solomon |
| 1998 | Harvey Jay Cohen |
| 1999 | William Hazzard |
| 2000 | Mary Tinetti |
| 2001 | Robert J. Luchi |
| 2002 | Larry Z. Rubenstein |
| 2003 | Itamar Abrass |
| 2004 | John E. Morley |
| 2005 | Wilbert Aronow |
| 2006 | Molly Carnes |
| 2007 | Andrew Goldberg |
| 2008 | David Reuben |
| 2009 | Stephanie Studenski |
| 2010 | Lewis Lipsitz |
| 2011 | Luigi Ferrucci |
| 2012 | Thomas M. Gill |
| 2013 | Richard M. Ullman |
The American Geriatrics Society was formed in 1942 by Malford W. Thewlis. The Journal of the American Geriatrics Society was launched in 1953.
The American Medical Directors Association was founded in 1978, with William Dodd being its first president. Its journal is called the Journal of the American Medical Directors Association (JAMDA), which in later years under the leadership of Professor John Morley became a high‐ranking geriatric medicine journal.
Leslie Libow created the first fellowship in geriatric medicine at City Hospital Center, New York (a Mount Sinai School of Medicine affiliate) in 1966. The following year he created the first teaching nursing home in the US. In 1982, the first Department of Geriatrics was formed at Mount Sinai Medical School. Dr Robert Butler was its first chairperson.
The first certifying examination in geriatrics was given in 1988. At the same time, two‐year geriatric fellowship programs were certified. In 1995, the fellowship requirement was lowered to one year. A decade ago, in March 2010, there were 7029 board certified geriatrics and 1705 board‐certified psychiatrists in the US. In 2008–2009, there were 470 geriatric medicine fellowship slots, of which only 62% were filled. Over two‐thirds of the slots were filled by international medical graduates. At the time of the last edition of the textbook (2012), there was one geriatrician for every 2699 persons age 75 or older in the US. At the present rate of recruitment into geriatrics, this will decrease to one for every 5549 older Americans by 2030. Physicians working in nursing homes can be certified separately by becoming a Certified Medical Director, which is offered by the American Medical Directors Association.
Over the last 30 years, the US has taken an important lead in developing the scientific base of modern geriatrics. Unfortunately, the lack of sustained interest by young physicians in geriatrics is likely to erode this over the next decade.
