America is aging. The first of the baby boomers -- people born between 1946 and 1964 -- are getting ready to enter their senior years. Who's going to look after them as they start to face the health problems that can come with age?

Geriatricians are the doctors who care for seniors. There's already a shortage of geriatricians in the U.S., and it's expected to get worse. That means there will be plenty of opportunities for geriatricians.

"With millions of baby boomers reaching retirement age, there is a growing shortage of geriatricians and other geriatric health care providers to care for them," explains Dr. Maura Brennan. She's the director of geriatric consultation at the Baystate Medical Center in Massachusetts.

"The estimated current need for certified geriatricians is 14,000. However, the U.S. has half that number. And while the overall number of doctors has increased over the last eight years, the number of doctors certified in geriatrics has dropped 20 percent, from 9,000 to 6,700."

But if we know the population is aging, why is there such a shortage? Experts say there are several reasons. One factor is society's view of the aging.

Geriatricians say we need to do more to expose young people to the world of the elderly. Many of today's high school students haven't had much contact with senior citizens beyond their relatives.

"High schools could put something in place to expose students to older adults," suggests Dr. Chris MacKnight. He's a professor of geriatric medicine.

"For example, there's a school that I'm aware of in St. Louis that's a combination elementary school and nursing home. If people in schools had more exposure to older adults then they might feel more comfortable with them."

Brennan agrees that schools could be playing a major role by introducing students to the field of geriatrics.

"Many adults and most children have no idea that there even is such a specialty as geriatrics," she says. "I don't think our society really stresses the joys of interacting with older adults. There is a lot of bias and fear that is directed towards seniors."

Popular media also contributes to this lack of exposure. While movies and TV shows glamorize emergency room doctors and all kinds of surgeons, you rarely see a geriatrician gracing the screen. To make matters worse, even those who decide to make a career of medicine don't get much exposure to the field once they're in school.

Medical students often have more exposure to other specialties like psychiatry, pediatrics, surgery and family medicine.

"There is very limited exposure to the field of geriatrics in medical school, although this is beginning to change," confirms Brennan. "Many schools are just starting to include geriatric topics in their lectures and clinical experiences."

Even if medical students are undecided about their specialty training, they may not consider geriatrics for other reasons. For starters, these students want to make sure that they can make a good salary.

"Right now, most medical students...are deeply in debt," says MacKnight. "They're going to be looking for an area where they'll be sure to get work and they'll be sure to earn enough to meet their debt load."

"And geriatrics is among the lowest-paying of the medical specialties," says Brennan. "Unless our whole approach to paying doctors shifts, this is unlikely to change in the near future."

Although government cutbacks to geriatric positions have also discouraged potential geriatricians in the past, many hope that as the government and the medical world become aware of the shortage in this field, there should be more positions for geriatricians.

"By 2030, we anticipate that there will be a need for 36,000 geriatricians to care for the number of adults aged 65 and older, which will have nearly doubled to 70 million," says Brennan. "Anyone who goes into geriatrics will have no trouble finding a job. New graduates from my program are usually courted by multiple potential employers while they are still in training."

A number of initiatives exist to increase recruitment to the field of geriatrics. Several foundations and organizations promote the specialty to young physicians, and all are committed to increasing the number of trained geriatricians.

For those who do enter the field, a wide range of types of jobs exists. Doctors could work in nursing homes and take care of very frail patients or choose to look after healthy older people in the community. Others may do much of their work in hospitals and assist other doctors as they care for the elderly. Many more could end up in research or private practice.

Because there are so many areas to fill, it is easy to find a good fit. And not only will graduates be able to find work in areas that matter to them, they are also likely to be happy with their career choice. In a study published in 2002, geriatrics was the field in which the most respondents said that they were "very satisfied" with their career.

That doesn't surprise either Brennan or MacKnight. "Geriatrics is a great field," says Brennan. "The patients are interesting and have fascinating life stories. They often have much to teach us in terms of strength of character and maturity. I look forward to coming to work every day.

"They are very appreciative, and true caring and attention by the doctor can really make a big difference in their lives. We just need to help high school students understand this."

And what you need to understand is really very simple. "You're helping people to lead a better life," concludes MacKnight.

Net Sites

The American Geriatrics Society
This group is active in all areas of the field, from research and policy making to hands-on health care
http://www.americangeriatrics.org

National Institute on Aging
This organization leads the "effort to understand the nature of aging and to extend the healthy, active years of life"
http://www.nia.nih.gov/

National Advisory Council on Aging
Canadian organization promoting a better quality of life for seniors
http://www.naca-ccnta.ca/naca_main_e.htm