Paul Tatum III, MD, MSPH
When I think of what it takes to build a better workforce to care for older adults across all of the US, the thing that comes to mind is that we need master educators who are geriatricians. These master educators will teach physicians (generalists and specialists), nurses, social workers, direct care workers, and patients and their caregivers how to provide care for older adults at both a system level as well as at the individual patient encounter. How will we ever teach all providers these skills if we don’t have specially trained teachers?
A key policy element for better care of older adults, therefore, is the restoration of the Geriatric Academic Career Award (GACA). The GACA is a five-year career award that allows junior faculty the opportunity to dedicate a large portion of their time to developing pedagogical and leadership skills to become influential clinician educators.
As a past recipient of the Geriatric Academic Career Award, I can speak firsthand to the importance of an academic career award. The GACA made all the difference in my career, and I know a number of other former awardees who would say the same. But don’t just take my word for it, you can see others speak to the importance of the GACA here in a series of video testimonials from former awardees.
And let’s look at the evidence:
In the Journal of the American Geriatrics Society, Dr. Kevin Foley of Michigan State and colleagues analyzed the impact of GACA awards. GACA awardees were highly positive about the impact of the award. Ninety-six percent stated that GACA support for education and academic development and leadership was critical to academic success. Most were successful in their projects and went on to academic promotion. They estimate that 102 GACA recipients reached a minimum of 40,000 learners and possibly more than 60,000.
The disruption of GACA funding in the midst of the fellowship led to half the group leaving the practice of academic medicine. In fact, at my own institution, one geriatrician hoped to receive a geriatric career award, but when the GACA was dropped she actually left geriatric medicine.
So how did the GACA impact me personally?
I would say it offered me three things:
- Flexibility: The career award allowed me to use dedicated time to focus on development of teaching skills. Without funding, this would not have been possible. I would have been pressured to use that time for revenue-producing activities.
- Formal pedagogical and leadership training: By being freed up with the award, I was able to pursue training to become a better educator. As someone who had been in private practice for 6 years before starting my academic career, I found this support to be essential to my development. I also attended a quality improvement training with Dr. Brent James – a founder in that field which helped me advance into national leadership.
- Mentorship: The GACA allowed me to create a national network of peer mentors who to this day help me with solving problems. I get consults from San Francisco, Denver, Birmingham and elsewhere around the country for problems I encounter. They make my work better!
And the result?
The GACA allowed me to develop curricula to train family physicians, internists and hospitalists to deliver better care transitions for patients with serious illness. It allowed me to have an impact in my institution to teach every graduating medical student and redesign curriula to teach basic geriatrics and palliative care skills. For my institution this is especially important because we train the majority of physicians who will practice in rural areas in our state.
The GACA also gave me the opportunity to advance in national leadership. Thanks to the GACA, I am now a member of the American Academy of Hospice and Palliative Medicine’s Board of Directors, a member of the American Geriatrics Society’s Quality Committee and a member of the Geriatrics and Palliative Care Standing Committee of the National Quality Forum. None of these positions would have been possible without the GACA.
Geriatric Academic Career Awards will give junior faculty the ability to spend their first few years developing teaching skills and programming skills that will allow them to be successful. Without building future generations of teachers so that every physician has basic geriatrics care skills, how will we meet the needs of patients , more and more of whom may be living with multiple serious illnesses? It is time to restore the GACA.
On May 14 2018, Senator Collins (R-ME) and Bob Casey (D-PA) introduced the bipartisan Geriatrics Workforce Improvement Act (S. 2888) in the Senate to reauthorize programs—including the GACA—that support interprofessional geriatric education, training and advance research to develop a geriatric-capable workforce, improving health outcomes for a growing and diverse population of older Americans and their families. This bill has a companion in the House of Representatives, the Geriatrics Workforce and Caregiver Enhancement Act (H.R. 3713) sponsored by Reps. Jan Schakowsky (D-IL), Doris Matsui (D-CA), and David McKinley (R-WV). Your voice of support will be critical to ensuring lawmakers in both chambers of Congress recognize the importance of these legislative proposals, which now must be reconciled and voted upon before they become law. For more information on contacting your U.S. Senators and House Representative, visit the AGS Health in Aging Advocacy Center at cqrcengage.com/geriatrics.
Dr. Paul Tatum is a geriatrician in Columbia, Missouri and is affiliated with University of Missouri Hospitals and Clinics. He received his medical degree from University of Texas Medical School.