American medicine is already in a crisis mode when it comes to geriatric care, and the problem will only become worse unless new approaches are found, experts say.

“There’s been a drastic decline in the number of geriatricians  and just 300 new ones are being trained each year  yet the number of people over 65 will double in the next 20 years,” Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston and an associate professor at the Harvard School of Public Health, said in an interview. “Those who work in geriatric care are among the worst paid in the health care system. Is the time I spend as a surgeon excising a patient’s cancer worth 10 times more than the time the primary care doctor spent finding the cancer in the first place?”

Dr. Gawande, who examined the problems of medical care for the aged last year in The New Yorker, pointed out that as we grow older, “we don’t get one problem at a time.”

“People with multiple problems need time, and that is not cheap and is currently not paid for by medical insurance,” he said. “It’s not possible to address five different problems in a 20-minute visit.”