Education, Training Needed for Managing Geriatric Otolaryngology Patients

While he was a Boston University School of Medicine fourth-year medical student with the Home Health Service, Brian McKinnon, MD, was introduced to the challenges of caring for the elderly patient. This unique educational experience left an indelible impression and has influenced his career interest in the care of geriatric patients with hearing loss.

However, as Dr. McKinnon and others have discovered, it is rare that students and residents are exposed to a dedicated geriatric educational experience. Unfortunately, most complete their training with little focused education addressing the unique problems of the older adult with otolaryngologic disorders.

Fortunately, there is a forward-thinking society of otolaryngologists dedicated to addressing this gap. The American Society of Geriatric Otolaryngology (ASGO) comprises otolaryngologists and other professionals who realize that the geriatric otolaryngology patient offers a unique challenge to healthcare professionals. This challenge requires a paradigm shift in how we train otolaryngologists, both to prepare them to provide healthcare to older adults and to educate others in the specific needs of this population.

David Eibling, MD, moderated a recent panel held during the American Society of Geriatric Otolaryngology Annual Meeting, held January 23, 2016, during the Triological Society Sections Meeting in Miami Beach, to better define and address the educational opportunities associated with the care of geriatric otolaryngology patients. Robert Miller, MD, Karen Kost, MD, Steven Parnes, MD, Carl Shipp, MD, and Brian McKinnon, MD, joined Dr. Eibling on the panel. This geriatric education panel considered the education and training opportunities that should be created to formally introduce otolaryngology residents, fellows, and colleagues to this topic.

Dr. Eibling opened the discussion by summarizing the conclusions of the 2009 Institute of Medicine report “Retooling for an Aging America.” The report noted that the shortage of geriatricians will dramatically impact the quality of care available for the aging population. Moreover, and not surprisingly, the only viable solution is the education of all physicians, and particularly specialists, to fill this void.

Geriatrician Shortage

The American Geriatric Society (AGS) anticipated the impending shortage of geriatricians more than a decade ago. Formed in 1942 by Ignate Nascher, MD, and Malford Lewis, MD, the AGS is a small organization dedicated to improving the health, independence, and quality of life of all older people. In the late 1990’s, the AGS executive council recognized the explosive growth of U.S. seniors—from 12% to a projected 20% of the population by 2030—and implemented the Geriatrics for Specialists Initiative, collaborating with eleven specialty societies, including the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Dr. Parnes, a past president of ASGO, represented the specialty of otolaryngology in the initiative and played a role in selecting specific learning objectives.