To the Editor:

As a family physician educator of more than 22 years, I was curious to hear what prominent physicians and health care leaders had to say in the article, “What Lies Ahead for Family Physicians?” [January 2000 special section: “Family Practice in 2000: The State of the Art”].

My compliments on the diverse group of professionals interviewed. Their diverging views on the future for family physicians were very interesting, but it was disturbing that the elderly were not mentioned once in any of the interviews, considering that older Americans will play an enormous role in health care in the next 25 to 30 years.

Geriatrics may not be glamorous and may be a time-consuming and ego-deflating area of medicine, but it is where the future of family medicine lies. In fact, there is light at the end of the tunnel for those of us who work in geriatrics. It works this way: There are two classes of elderly. The minority are well elderly who are good HMO risks; the majority are plagued with chronic illnesses and multiple problems and are not good HMO risks. It is this high-risk Medicare population that appears to be the last bastion of fee-for-service medicine! Taking on these patients may be good medicine for what ails family physicians.