Doctors: Treat the Patient, Not the Age

My Pilates teacher is a fantastic person. Seeing her long auburn hair swinging as she walks around a room greeting new students is an inspiring sight. A top-ranked tennis amateur, Victoria exudes health, is beautiful and in top condition. She’s also 56 years old, even though she doesn’t look like the stereotype most people have of a woman that age. She takes excellent care of herself and it shows.

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But when she suffered a minor back injury on a skiing trip and was sent by her doctor to a physical therapist, her looks and health were discarded, and she became simply another “senior” citizen. Her age, not her strength, determined the attitude and the condescension of her physical therapist and his office.

“I was treated like a person who was old and not of any particular value,” Victoria told me. “The therapist had a way of speaking to me that I found insulting. Believe me, when I heard him speak to younger patients, his whole demeanor and tone were markedly different. He used phrases to me such as, ‘At your age, you’ll probably have to give up many of your activities,’ and, ‘At 56, you need to know that you’re not a young woman anymore.’ The worst one was, ‘Tennis? Oh, I wouldn’t advise you to do that anymore.’ I was incensed! I’m 56 and in perfect health! I needed some therapy for a minor problem. His treatment of me made me mad.”

Victoria did what any self-respecting, intelligent, and mad-as-hell woman would do: she called her doctor’s office, told him what the therapist had said, and requested his professional help. Her doctor, a man in his 50s himself, was annoyed by what her therapist had told her.

“You’re healthy and in excellent condition,” he told her. “Let me give you the names of several other therapists in your area. And let me tell you that I am putting a call in to that therapist. He’s treating your age, not you as a healthy, fit patient.”

Victoria interviewed the new therapists by phone, told them that she wanted to be in charge of her physical therapy, and that her injury, and not her age, was what was being treated. Within a couple of months, with the kind of excellent, respectful physical therapy she expected, she was back to doing everything she loved, including tennis.

“The idea that anyone out-of-hand treats the age and not the patient is something that has to be changed, and those over 50 have to be the ones to do it,” she says. “What is this fixation with numbers? Certainly our overall health is so much more than a number, and we need to make that fact known at the beginning of any doctor-patient relationship.”

Mark Lachs, M.D., director of geriatrics for New York-Presbyterian Healthcare System and author of the book “Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care As You or a Loved One Gets Older,” would have been proud of Victoria. He espouses treating the patient and seeing the age as only one of the components that make up the whole. Respect should always be part of the any treatment, and when a person is treated solely on the basis of antiquated “age-thinking,” there is a problem. The over-50 set needs to learn how to navigate a complex and confusing age-related healthcare system and mindset to make the best choices that will lay the groundwork for a satisfying, active lifestyle that lasts well into advanced decades.

It is totally unfair that the culture in the USA tends to define the natural process of aging in a negative manner. Unfortunately, this definition of aging widely exists in our healthcare system, where “ageist” medicine is, more likely than not, practiced. This attitude often serves to worsen the medical issues rather than helping the patient figure out how to address health problems or prevent and avoid them.

Although it seems to be more necessary for those over 50, we all need an “insider’s guide” to help us stay healthy and demand to have healthcare personnel treat the health problem and not the age. Any woman who is in her childbearing years knows that any physical complaint she may have is first connected to her menstrual cycle and the possibility of pregnancy. Those factors have nothing to do with over 90 percent of the cases, yet that is the first thing a doctor will suspect in a woman “of childbearing age.”

Medicine and attitudes about treating older Americans need to understand that a 56-year-old woman or man of today is healthier, more active and fitter than either their parents or grandparents. Nutrition and a healthy lifestyle play an important part in a person’s overall health, and that should be taken into consideration when treating the patient.

As for Victoria, she very subtly made her point about fitness and age. She competed in, and won, a national tennis mixed doubles match a year after her back injury. Victoria and her male partner were prominently featured in a tennis magazine, and she sent the clipping to the therapist who had smugly told her that a minor back injury was the end of the line for her tennis-playing days.

Her reward came a week later. The therapist sent her congratulations along with an overdue apology.

Read more from Kristen Houghton on her website