What do white hair, a few extra wrinkles, or the number of candles on the birthday cake really say about an older-adult physician’s ability to contin
ue practicing medicine?
Do they necessarily mean the physician is slowing down? Are they losing their clinical acumen or skill? Should their ability to practice be restricted? With recently published research showing that older-adult physicians often feel dismissed or “invisible” to younger colleagues, an AMA “Prioritizing Equity” video panel discussion featured expert insights on this issue from several physicians:
- Jenny L. Boyer, MD, PhD, JD, chair-elect of the AMA Senior Physicians Section (AMA-SPS) Governing Council.
- Ramona L. Rhodes, MD, MPH, MSCS, a geriatrician, hospice and palliative medicine physician in Little Rock, Arkansas.
- Ved V. Gossain, MD, retired endocrinologist, former chair of the AMA-SPS.
The discussion was moderated by William B. Jordan, MD, MPH, who is senior director of equity policy and transformation at the AMA Center for Health Equity. Panelists examined the quality of care older-adult physicians provide, how age-related biases affect older-adult physicians, and how ageism affects patients’ care experience.
The panel also discussed the effects of ageism and personal experiences, and the policy changes needed to ensure that all physicians—regardless of age—can continue to contribute meaningfully to patient care.
“We'll explore why hospitals and regulatory policies should shift from focusing on a physician's age to evaluating their quality data and performance metrics,” Dr. Jordan said.
Metrics—not age—should lead decisions
Dr. Rhodes called attention to parallels between the ageism that confronts older-adult patients and that which affects physicians 65 or older.
“There are several parallels between age-related bias that patients may experience and the experiences of older physicians, because they can both be victims—for lack of a better word—of what are considered negative assumptions and stereotypes that are based solely on their age,” said Dr. Rhodes, a member of the AMA Medical Justice in Advocacy Fellowship in 2021–2022.
Older adults “can be stereotyped as being less capable, more likely to have memory problems, and less engaged, and health care providers—from the patient perspective—may be less likely to recommend aggressive treatments for complex procedures based on a patient's age alone,” she noted.
“And the parallel to that, from the physician perspective, is that some physicians may have limitations placed on their practice that are based on assumptions around their age.”
How can the U.S. health system address ageism against older-adult physicians? Dr. Gossain said it is vital to keep patient safety paramount.
“We need not only to educate our colleagues, our medical students, our residents, but the administrations of the hospitals, and, in my case, the university as well,” he said. “And the principle that we need to have in terms of advocating on ageism is that all physicians have the right to remain in practice as long as patient safety is not compromised and they're providing appropriate and effective care.”
The health care industry should follow the standards developed by the AMA that decisions related to older-adult physicians “must be evidence-based, ethical, relevant, accountable, fair and equitable, transparent, supportive and nonburdensome.”
Learn more with the AMA about nine principles to guide physician competence assessment at all ages.
Stay updated on the fight for greater health equity.
New research on ageism in medicine
Dr. Boyer noted that the AMA-SPS last year “had an education program on ageism, and we also in that program highlighted structural ageism and its impact on society, and that affects laws, practices and cultures.”
The AMA has also published two studies highly relevant to older-adult physicians, both of which list Dr. Gossain as a co-author. One study, published in the American Journal of Lifestyle Medicine, is “Loneliness and Associated Factors Among Senior Physicians in the U.S.” Researchers found that nearly one in five senior physicians—18%—reported high loneliness.
The other study, published on the AMA website, is “Experiences of Ageism Among Senior Physicians: A Qualitative Study,” which shows that many older-adult physicians experience ageist treatment. The report details the frequency and types of ageism they experience and recommends ways to address the phenomenon.
This study reports that among U.S. physicians who have reported experiencing some type of differential treatment in any part of their lives due to their age, 18.8% said they had been treated as irrelevant or they had been dismissed, disrespected or made to feel invisible.
“Age stereotypes can result in differential treatment in a variety of ways; treatment of older individuals in any way other than how one would treat others, based on certain notions or attitudes about that age group, can result in perceived benefits or disadvantages for those individuals,” says the report on experiences of ageism.
Ageism is prevalent, ubiquitous and insidious, said Dr. Gossain in the AMA “Prioritizing Equity” video.
“It largely goes unrecognized and unchallenged. The World Medical Association recently asked for the AMA's input on their ageism policy,” he said. “The AMA is advocating for performance-based evaluations rather than age-based policies in hospitals and regulatory settings.”
Learn more about the AMA-SPS, which gives voice to and advocates on issues that affect senior physicians, who may be working full time or part time or be retired.
