Annual salary for a geriatrician: Less than $16,000. “As an internist who obtained certification in geriatrics the first year it was offered, I found your editorial on the graying of America to lack a full understanding of the problem.

No one in a practice that is not subsidized by other physicians, or has ancillary income such as lab or X-ray, can afford to be identified as a geriatrician today. A practice population of more than 40 percent Medicare patients is the kiss of death.

If I were to see only Medicare patients for 15-minute office visits, 40 hours a week, 48 weeks a year, with 2 percent inflation of practice and malpractice expenses, along with the current fee reductions planned for Medicare, my annual income four years from now would be less than $16,000.

That is why there will be limited access to the specialized skills needed to care for our aging population.”