It would seem reasonable for licensing boards to require additional training in geriatric care, but they don't. I've seen required training that was a joke. Yes, money plays a BIG role but so do hospital corporations that are driving the practice. When bloodwork costs $125 outpatient and hospitals charge over $300, you have to see it right there. Eye exam was $125 and now it's over $300 for the same thing. They charge Medicare 3-4x what they know they will get. Charge the remainder as a tax benefit loss? I'll bet they do. One surgeon stopped doing kids' ENT surgeries because he told me, "You think I'm going to operate for what they pay me? No." So, kids don't get the surgery. It is a mess everywhere.