Ageism in Medicine Must Stop, Experts Say


Ageism is not only prevalent in society, it’s also widespread in medical education and in the clinic. This situation, say leading experts, results in substandard care and poor outcomes for older patients.

A symposium here at the American Association for Geriatric Psychiatry (AAGP) 2018 Annual Meeting focused on this problem and possible solutions.

Kirsten Wilkins, MD, associate professor of psychiatry and psychiatry clerkship director at Yale University School of Medicine, West Haven, Connecticut, told meeting attendees that thinking of older people as innocent, cute, adorable, or fragile and in need of protection may seem positive but in fact reflect stereotypes. Such attitudes, as well as infantilizing elderly patients, may seem helpful but are aspects of inherent bias.

“This can lead to some paternalistic prejudice. These patronizing behaviors may seem benign, but they’ve actually been associated with negative health outcomes,” said Wilkins.

Unlike racism and sexism, “ageism is the only ‘ism’ that is socially sanctioned and considered to be normative,” said Susan W. Lehmann, MD, associate professor of psychiatry and behavioral sciences at Johns Hopkins Medicine, Baltimore, Maryland.

“We don’t really acknowledge ageism, but it’s in medical education settings. It’s in the hospital where we’re training our residents and where we’re training our medical students,” said Lehmann, who is also director of the Geriatric Psychiatry Day Hospital Program at Johns Hopkins.

Seeing Beyond the Stereotype

W. Bogan Brooks, MD, psychiatry clerkship director, University of South Alabama College of Medicine, Mobile, noted that previous research has shown that ageism can lead to undertreatment, particularly for complaints of pain, fatigue, depression, sexual disorders, and cognitive impairment, as well as overtreatment, with needless tests, procedures, medications, and admissions to the intensive care unit.

“On the average, an older adult goes to see the doctor about 12 times a year. These doctor visits represent a lot of opportunities for physicians,” said Brooks. But past research has shown that “because of ageist attitudes, doctors can be guilty of undertreating conditions if they attribute patient complaints to ordinary aspects of aging.

“Alternatively, doctors can be guilty of overtreatment if they label expected changes as a disease,” he added.

American Association for Geriatric Psychiatry (AAGP) 2018 Annual Meeting. Session 108, presented March 15, 2018.

Deborah Brauser, March 19, 2018

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