The aging of family medicine.

A recent editorial in The Globe and Mail claimed that the issue of reining in Canada’s health care costs was mostly ignored by politicians in the recent federal election campaign.1 Furthermore, The Globe argued that fixing Canada’s $192 billion health care system should begin with the elderly—the fastest growing segment of our population, with almost 5 million people aged 65 years and older now and more than 10 million expected by 2036. One of the solutions called for in the editorial was to train more geriatricians—Canada currently has only 238 of them and experts say that 500 more are needed.1 It has been very difficult to interest medical students, residents, and practising family physicians in the care of the elderly.2 There are many reasons for this. There is evidence, for example, that family medicine residents do not understand the demographics of the future in which they will practise. In a US study by Helton and Pathman,3 family practice residents reported very positive attitudes toward elderly patients, yet only two-thirds of them thought that elderly people would make up a substantial part of their practices. Another factor, cited by Weiss, is the possibility that geriatric medicine as currently taught in medical school and residency programs is seen as overwhelming, depressing, or both.2 To quote Weiss: