Age Bias Affects Healthcare for the Elderly

The PewResearchCenter released results of its November ‰Ûª08 study on the increasing generation. Here are some eye opening statistics. When does old age begin? The average American says 68. Those under 30 say it is 60. Those over 65 say it is 74.

Conan O‰ÛªBrien‰Ûªs average audience age dropped 10 years from Leno‰Ûªs and that was considered a good thing because advertisers crave younger viewers even though boomers and elders hold the majority of wealth in the nation.

And then you come to healthcare for the elderly. New interns are starting in hospitals across America. Young fresh faces whose definition of old is highly exaggerated and who have received no training in geriatric medicine. All medical students are required to rotate through pediatrics and obstetrics. There is no such requirement for geriatric medicine despite the fact that a third of physician‰Ûªs patients are over 65 and almost half of specialist patients are too. Medicare contributes more than $8 billion a year to support residency training, yet it does not require that part of that training focus on older adults.

There is great essay on this in the New York Times by Rosanne M. Leipzig, a physician and professor at Mount Sinai School of Medicine. She argues that those receiving Medicare money should be required to demonstrate that their trainees are competent in geriatric care, that Medicare should finance medical training in nursing homes, and that state licensing and medical specialty boards require demonstration of geriatric competence for licensing and certification.

Basic geriatric knowledge is preventive medicine she says and I agree. Is it any wonder that mis-handled and diagnosed older patients end up worse off then when they present with their illnesses? And then where do they end up ‰ÛÒ in the long term care world.

You may require all the things she argues for and people will follow the rules to get paid or licensed but that does not take into consideration the general tone of the culture whose definition of old is warped, where the wisdom of our elders is not cherished, and where their contribution ends at retirement in the eyes of many. We need to change not just healthcare for the elderly but a culture that is obsessed with youth.