The Otolaryngologist and the Imminent Crisis in Geriatric Medicine

Additionally, educational resources in geriatric otolaryngology directed at the field as a whole are growing rapidly. The American Academy of Otolaryngology- Head and Neck Surgery, through the efforts of its geriatrics committee, has done great work in bringing specific geriatric topics and principles to our field. The committee has developed an online free text titled Geriatric Care Otolaryngology Online (www.entnet.org/EducationAndResearch/geriatricOtolaryngology.cfm ). The text covers geriatric topics across the field. The committee has also sponsored a number of geriatric-focused miniseminars, and members of the committee are increasing the number of instructional courses in geriatrics at the annual Academy meeting.

Furthermore, Calhoun and Eibling have published the first comprehensive textbook for the subspecialty: Geriatric Otolaryngology (Dekker, 2006). Our colleagues have done an excellent job creating resources for learning in geriatric otolaryngology topics. More work integrating basic geriatric care principles and working on ways to improve penetration of the fund of knowledge into the field as a whole are important next steps. Achieving this is one of the missions of both the Geriatric Otolaryngology Committee of the Academy, and of a new society, the American Society of Geriatric Otolaryngology. ASGO meets annually immediately prior to the Combined Otolaryngology Spring Meeting and offers a diverse program on geriatric otolaryngology topics. The ASGO Web site also offers access to a number of geriatric otolaryngology resources (www.geriatricotolaryngology.com ).

Most otolaryngologists have a substantial number of geriatric patients in their practice and thus are practicing geriatric otolaryngology. If we recognize this and also acknowledge that understanding of the basic principles of geriatrics will improve our care of older patients, then it makes sense that specific geriatric criteria be integrated in the certification and maintenance of certification process, as the IOM suggests. This straightforward change will help drive training programs to include learning experiences that will enhance the care of older patients.

Summary

We are on the crest of dramatic growth in our elderly population, and substantial changes will be required to provide health care for them in the way they deserve. Specialists will not be immune to the changes that will come, and we need to prepare. We need to lean on our leaders to work for increased payment for geriatric care. We also need to improve our knowledge and competence in geriatric care as a whole. Hopefully, we will all be able to individually reap the benefits of the changes to come in how we care for our aging society.