The rising problem of ageism in healthcare
Ageism in healthcare is very real.
Whether the patient is young or old, many find themselves dismissed, mistreated, or even bullied by their nurse or doctor. In fact, ageism is so prevalent in healthcare that studies have been conducted to better understand its effects.
One such study is from 2015 in the Journal of General Medicine. The study found that one in five respondents over the age of 50 felt that they had experienced discrimination in healthcare because of their age, and one in seventeen respondents felt the discrimination they faced by their doctor worsened their disability by four years.
Ageism isn’t only experienced by patients over the age of 50. Young patients and even young doctors experience it, too. With young doctors, they’re often met with skepticism by their patients who fear they may be too inexperienced to help them.
Let’s dive into ageism across the healthcare field and how it affects patients and doctors alike.
Discrimination against older patients
Ageism toward older patients is one of the most prevalent examples of bias in healthcare.
Older patients are often viewed as a monolith instead of unique patients with unique needs. Stereotyping older patients is not uncommon, and acting on preconceived notions of older patients can be dangerous.
The two most common outcomes of ageism towards the elderly are under-treatment—dismissing the patient’s symptoms based on age—and over-treatment—providing too many tests or medications based on age.
A 2018 study found that overtreating patients with type 2 diabetes led to an increase in hypoglycemia in 20 percent of patients, and 30 percent of patients experienced an increase in falls. Overmedicating is a serious issue with the elderly, with one in three seniors having at least one bad drug reaction, and two-thirds needing medical attention because of it.
In the case of undertreating older patients, pain is an excellent example. In his 2006 paper “Management of Pain in Older Adults,” Thomas A. Cavalieri, DO, writes, “The elderly are frequently untreated or undertreated for pain because of barriers to recognition, assessment, and management in such patients.” Older patients don’t always convey the amount of pain they are in, and doctors don’t always understand the pain the patient is in. This can lead to older patients experiencing debilitating pain that goes untreated.
Ageism toward the elderly can also come in the form of flat-out disrespect and lack of empathy.
Tristan Mercado from Austin, Texas, knows this all too well. Her mother is currently suffering from Lewy body dementia, the second most common dementia after Alzheimer’s, and Tristan is her caretaker. Tristan looked into adult daycare out of the home for her mother and was shocked by what the intake specialist on their first meeting said to her: “You know you could put her in a full-time facility and sometimes when they are miserable enough, they will themselves to die.” Tristan walked straight out of the meeting.
One of the most common complaints with older patients is that their doctor or medical staff view them as someone who isn’t of sound mind and who isn’t worthy of being spoken to as a functioning adult.
Discrimination against younger patients
Unlike older patients, younger patients more often experience undertreatment due to their age.
Young people aren’t supposed to get certain diseases, according to medical books and statistics, but they do—time and time again. Because of this, inappropriate assumptions are made, and they’re often dismissed.
In 2011, Lindsey Kinsolving from Houston, Texas, needed surgery to remove an orange-sized cyst from her ovaries. Knowing that the machine used to remove the cyst is the same machine used to perform hysterectomies, Lindsey asked the doctor if he could perform a hysterectomy on her as well. Lindsey knew she didn’t want children, and that a hysterectomy would spare her future painful cysts and expensive doctor appointments.
“I was told absolutely not, was actually laughed at, and told that I might change my mind and they don’t perform them on women that young,” Lindsay said.
Her story is similar to many complaints young patients have: They’re not taken seriously because of their age.
Over and over, young cancer survivors have spoken of sharing early symptoms with doctors only to be dismissed because they were too young to have certain cancers. For example, colon cancer is currently on the rise in people under the age of 50. While researchers are still not sure what is causing this uptick, young patients are waiting months to get a diagnosis.
A 2019 Colorectal Cancer Alliance survey found that 67 percent of early-onset colorectal cancer patients saw at least two doctors (and as many as four) before getting diagnosed, leading to stage III or IV diagnoses for 71 percent of those surveyed. It took 217 days for cancer patients to receive treatment since the first symptom.
Discrimination against medical professionals
Patients aren’t the only ones that experience ageism. So do doctors.
For generations, patients experienced predominantly older doctors. This stereotype still lingers in the minds of some, who may be shocked when they encounter a doctor 10, 20, or even 30 years younger than they are.
Most patients may laugh it off and jokingly say something like: “You look too young to be a doctor.” But some patients take issue and ask for an older doctor. This can be particularly frustrating for young doctors.
On a thread titled “Look Too Young?! Most Annoying Comment Ever” on The Student Doctor Network, one young medical professional said that they get told they look anywhere from 10 to 16 years old. They are told it so often that they feel like quitting their job. However, most doctors shared that they try to laugh it off and make jokes with their patients.
When ageism occurs between peers is when it can get really challenging. Young medical professionals, particularly women, are often dismissed by their colleagues when they look too young. Sadly, disrespect from colleagues is a top five factor in causing physician burnout, so steps need to be made to help combat ageism, sexism, and any other bias amongst medical professionals.
As you can see, ageism is a huge problem in healthcare, with many facets. Thankfully, interventions are underway and will hopefully, over time, fix the issue. Until then, we can all be more aware of the problem, call it out when we see it, and report it whenever possible.