You've probably heard about age discrimination in the workplace. And maybe you've even seen it in the doctor's office with a parent or spouse--that moment when the doc dismisses your 70- or 80-year-old loved one's complaint of an ache or pain as "just part of getting old," and then sends her out the door without a thoughtful or thorough evaluation so he can move on to the next "customer."
But have you ever stopped to think that the medical care you get as someone boomer-aged or younger--care that you may have dismissed simply as generically underwhelming--might also have its roots in ageism? I'm an internist who cares for younger adults as well as a gerontologist who cares for older ones, and I'm telling you it's out there. After all, you don't get old overnight. So why would you think that the age discrimination we know goes on in health care starts suddenly when patients turn 65 or 75?
In truth, its younger victims are surprisingly varied. They include the 50-something weekend-warrior athlete who gets injured but is told only to slow down, rest for a few months or switch to golf, instead of being offered (or even informed about) an aggressive procedure or physical therapy that could have them back on the field. If the doc doesn't think you'd need it, want it or tolerate it, you won't even get the option--even though weekend sports may be the most important thing in your life.
Then there's the 40-something woman with a large family who is guided towards a hysterectomy to treat uterine polyps because the doc just assumes "you're done and don't need a uterus anymore." Or how about the single 60-year-old in for an annual physical (the adolescent unit in my business) who gets every last screening test known to man--cholesterol, mammograms, colonoscopy--but doesn't get a single question about safe sexual practices, because we all know that no one over the age of 60 has sex?
Do you see I mean? You may have suffered this type of care and dismissed it as generically "bad," when in fact, it has its roots in subtle age discrimination.
So why does this happen? I don't think it's because the medical profession is discriminatory on purpose, but rather because we medical men and women are members, and mirrors, of a society that worships and is drawn toward youth. All things being equal, who do you think gets a more attentive evaluation of possible appendicitis in an emergency room, a 22-year-old fashion model or a 52-year-old homemaker?
There are other factors at work, too. As medicine gets more pressured and hurried, many doctors tend to take more of a "cookbook" or "age-focused" approach rather than look at the individual -- the living, breathing patient sitting across from us on the exam table with all his or her uniqueness. But there's a problem with that: we may have all been created equal, but we just don't age that way -- not mentally, and not physically. That's why appropriate care requires a patient-centered approach, not an age-centered one!
Whatever the reason for age discrimination in health care, it's important to recognize when it's happening to you. When you see medical ageism in action, you can gently steer the conversation (and your care, or the care of a parent or loved one) to the patient-centered approach, because age is only one of a host of factors; it shouldn't dictate your care. We geriatricians have a saying: "If you've seen one 80-year-old, then you've seen one 80-year-old." That's also true of us at 50, 60 and 70. I have 60-year-old patients who are home-bound and others who can whip me in a set of tennis. Why would I assume they would all want or need the same type of care?
In my next installment, I'll tell you how to recognize when you're experiencing ageism in the medical encounter -- at any age -- and what to do about it. And if you're interested in more detail about how to get the best health care for you or a loved one, visit my site www.treatmennotmyage.com.
Follow Mark Lachs, M.D. on Twitter: www.twitter.com/DrMarkLachs
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Yes, you have to own your own health care, get multiple opinions and question everything. Sadly, medicine is an art practiced by flawed human beings.
Very good point about the many unnecessary hysterectomies because the doc just assumes "... [you] don't need a uterus anymore."
If a man has decided to have no more children, are his organs removed? NO! So the unnecessary hysterectomies are not not just ageist but also sexist.
Three of my relatives are dead because of doctor neglect. My spouse's dad is on the same track; he had a failed back surgery that left him unable to stand up, and the meds have robbed him of his ability to taste food. He's lost 30 pounds and is still losing weight. Their response? "You're old and there's nothing we can do."
It's not ageism. These quacks have an excuse for not doing their job no matter what your age or gender or even ability to pay.
I worked as a medical illustrator for some time, and heard the stories the docs tell on each other. It's frightening. I avoid the medical profession as much as possible; I've met only two doctors who were competent, who listened to their patients, and who did their job.
It maybe the pressures of today's harried schedules but I find doctors are quick to dismiss complaints as stress, depression, or the almighty 'virus'. They may figure that if you are sick enough, you will come back and perhaps that will start the serious investigation.
Indeed, ran into such a doctor the other day. I believe this particular doctor deserves to be disciplined. I am lucky I am assertive and take charge of my medical needs; he's lucky I am too busy to complain about him.
In fact it is a label that exactly captures the ageist sentiments about which the doctor is talking.
I look forward to your next installment about what I can do about it.
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My rabbi, who works with a lot of older people, says that they are one of the groups most at risk for STD these days, because they *don't* get this information and figure that everything is great because pregnancy is no longer a worry. Haven't the doctors seen all those Viagra ads, or do they just think the guys take it for dancing or walking outside in soft focus (which is pretty much all those people do)?
Keep up the good work.
www.AnyShinyThing.com, A Blog for Smart Women of a Certain Age