For years, the healthcare industry, government and media have warned about the physician shortage and yet it continues to get worse. For physician recruiters hoping to hire geriatrics specialists, it’s hard to imagine how much worse things can still get. With such a limited supply and growing demand, recruiting geriatricians might require a complete overhaul of your recruitment strategy. By evaluating what geriatrics specialists want, you can update your job postings and develop creative ways that could make it feasible for recruits to join your practice. With that in mind, here’s a look at why it’s difficult to recruit geriatricians, what geriatrics specialists want and what physician recruiters across the country are doing to attract them.

Why is it difficult to recruit geriatricians

In 1996, there were 8,424 board-certified geriatricians in the United States. In 2013, the number plummeted to 3,590 according to the Bureau of Health Workforce. Today, with an older population of nearly 53 million, there are 7,300 board-certified geriatricians, which is fewer than 1 percent of all physicians, according to the American Geriatrics Society. 

One of the obstacles with recruiting gerontologists is the declining enrollment into geriatrics fellowships. “In 2024 only 41% of the nation’s fellowship spots in geriatrics were filled,” explains Dr. Julie Gammack, a professor in Geriatric Medicine at Saint Louis University (SLU) School of Medicine. “Geriatrics has the lowest fill rate of all the internal medicine specialties and has been declining over the past 5 years.”

Another obstacle is the less competitive salary for geriatricians compared to other cognitive specialists. “One of the reasons people have given for not going into geriatrics,” Dr Gammack says, “is because the salary is so low. And it is. When I looked it up, the geriatrician salary is about 9% lower than a general internist’s and 14% lower than a hospitalist. Neither of those positions require fellowship training. So it’s kind of crazy to do an extra year of fellowship just to get paid less.” 

Geriatricians who choose that pathway knowing about lower salaries do so because they genuinely love the clinical care of older people. That doesn’t mean they’re willing—or necessarily even able—to settle for a lower salary. Aside from allowing geriatrics specialists to feel valued and help improve their physician quality of life, a higher salary can help them survive. According to Dr. Parnika Prashasti Saxena, program director of geriatrics psychiatry at Stanford Medicine, “Unfortunately, medical school pricing is going through the roof. Cost of living is going up. It is harder to attract those with debt and young families.” 

As a physician recruiter, fully understanding geriatrics and how it differs from general internal medicine, family medicine and psychiatry is a must. According to Dr. Angela Sanford, associate professor of IM-Geriatrics at SLU “Many people don’t know that a geriatrician, in most cases, is really someone that does primary care for older adults.” 

Geriatric medicine and geriatric psychiatry encompass the care of patients 65 and older, elderly health, aging science and gerontological care, including illness, complex comorbidities, aging, cognitive decline, limited mobility, polypharmacy and social issues. They also tend to be better or more experienced at end-of-life issues and talking to patients and families about their goals at the end of their life. Most service multiple care settings, including the hospital, clinics, nursing homes, assisted living facilities and private homes—sometimes all in one week.

What geriatrics professionals want

Geriatrics specialists want the support and resources to develop and share materials about what they do and to educate others on caring for people 65 and older and related topics. 

Unlike most physicians who can quickly assess patients of all ages, geriatricians only work with patients 65 and older. Doing that properly can require more time. Dr. Sanford explains, “My visits are not ten or 15 minutes like some internists. I get 30 minutes for a follow up visit and 60 minutes for every new patient. I don’t crank out huge numbers of patients every day. In the nursing home, I can work a little faster, but still, the most I would ever do in one day is about 12 patients.

Geriatricians also require the autonomy to work in different care settings, and access to a reliable team of specialists with whom to discuss patient care plans. Dr. Gammack explains, “We work as an interdisciplinary team. By regularly working in a team approach, we understand the role of physical therapists; we know occupational therapy, speech therapy, nutritionists and social workers, especially in different care settings. I work with a whole team of different specialties and disciplines. We come together, literally sitting at the table, coming up with the best plan for the patient from each of our viewpoints.”

As experts in their field, geriatricians want better salaries. “Geriatricians are hard to come by,” says Dr. Gammack. “And unfortunately, we’re in one of several cognitive specialties where we get more training to make less money than our peers with less training.  It is a flaw of our health care system, but it’s what it is. If an organization wants to recruit a geriatrician, they might want to think about paying them something that’s a little bit more enticing. Maybe pay them what a hospitalist would make.”

What recruiters are doing

To recruit careers in geriatrics, it’s important your organization’s geriatric job description stands out from the others. Listings for geriatric physicians, psychiatrists, NPs and APPs on PracticeLink’s job board vary from narrative descriptions of the role and community to a bare bones approach focusing on the salary and benefits.

  • Prisma Health in South Carolina invites geriatricians to “Be the difference” and stands out by listing two unique opportunities: Help develop a geriatrics fellowship and pursue academic interests by teaching at University of South Carolina School of Medicine Greenville.
  • LTC Physician Care, PC in Michigan offers a sign on bonus in its post for a geriatric nurse practitioner, as well as CME allowance including paid time off for CME attendance, cell phone stipend and reimbursement for medical licenses.
  • CHI Health Clinic in Grand Island, NE (part of CommonSpirit Health) describes its compensation for a gerontologist as “lucrative” instead of simply competitive. They also offer relocation expenses, five weeks paid time off and CME allowance.
  • The post for a geriatrics physician at the VA’s Pacific Islands Veterans Healthcare System also offers 5 weeks paid time off (which include federal holidays), 13 days sick leave that can be rolled over and five days to attend a CME course. Additionally, the VA boasts details of the federal retirement plan including the perk of being vested in the federal pension after five years. 
  • Citizens Memorial gives applicants the choice of being 100% based in the facilities or the option to include an outpatient clinic. Compensation includes residency and training stipends, a sign on bonus, relocation stipend, student loan assistance and a retirement match. Additionally, they highlight their status as being PSLF qualified.

That’s not to say recruiters can’t be selective. In spite of the shortfall, Summer Pharr, senior recruiter at Lange Recruitment Specialists, continues to look for evidence of the applicant’s qualifications and core competencies to confirm they’d be a good fit.

  • “Older adults often face complex medical, emotional, and social challenges… so empathy and compassion are some of the most important traits we look for. I want someone who can really take time to listen to patients and build trust during the exam. 
  • “Having patience and strong communication skills is important for both the patients and their family. As well as someone who is flexible and has problem solving skills because a patient’s status can be constantly changing and sometime change very quickly. 
  • “Aging patients often have multiple medical issues – so they need to be comfortable assessing a wide array of co-morbidities, have a solid understanding of polypharmacy and medication management. 
  • “I like to see a team mindset as well – these physicians often collaborate with other healthcare professionals like nurses, therapists and social workers. My clients are typically looking for a team approach to provide the best care. 

Most of this comes to light in video interviews. “I have a comprehensive zoom interview with our candidates. Just getting to know them and listening to their personal strengths and interests can tell me a lot about how they will interact with their patients. I also ask for examples as well—from them and their colleagues. 

“We are looking for candidates that are sensitive to cultural and gender differences – as well as respecting diversities associated with aging – such as hearing, visual and mental challenges. These issues can affect communication during exams so providers need to be able adjust and make sure that patients feels as comfortable as possible – so their visit can be as productive as possible.”

How organizations can develop compromises

If resources are scarce, healthcare organizations can get creative and develop enticing compromises. 

  • Reduce the number of hours worked and building partnerships with other care settings to help shoulder a higher salary.  
  • Offer J-1/H-1B visa sponsorship. 
  • Build in administrative responsibilities similar to Sutter Health’s California Pacific Medical Center in San Francisco  By combining clinical work which is limited to CMS reimbursement with administrative duties. The geriatrician’s salary can be pulled from different sources. 
  • Create an infrastructure and the culture in place that would be welcoming.”
  • Partner with a nursing home or assisted living facility that needs a Medical Director. They could work there one day a week, and their salary could be bumped up, maybe, $60,000 a year. 
  • Develop a concierge clinic for older patients with commercial insurance or who can pay out of pocket.
  • Apply for a grant. Health Resources and Services Administration (HRSA) is a federal agency that provides grants to healthcare organizations for specific initiatives. For instance, organizations with drug abuse treatment facilities, such as VA medical centers, Kaiser Permanente in California and Wexner Medical Center at Ohio State University, can leverage HRSA’s grant for Substance Use Disorder (SUD) treatment to address substance abuse among older people. 
  •  Assist with loan repayment programs. A lot of paperwork is involved with state and federal loan repayment. Provide legal support to help them successfully navigate the process.