Tuesday, June 10, 2014

Ageist Attitudes in Healthcare Professionals

Ever notice how you are treated by any healthcare professional, especially if you're over the age of say 60 or so? Oh, what about when you reach Medicare eligibility? Is there a change in how you are perceived and how your wishes or needs are handled? Take one example, and it's a valid one, in the area of dermatology.

As we age, our skin undergoes changes, some subtle, some rather dramatic, that are startling and often distressing and looking in the mirror becomes a task we'd rather avoid. This goes equally for men and women. All of us want to look good and be fit and something akin to our yougner selves, unless we're depressed about something and heaven knows aging brings on lots of that.

When you go to a dermatologist, you probably are beginning to develop or have developed some of those dreaded "age spots" or "senile plaques" that dermatologists are seeing in most older adults. They may begin like small light discolorations but grow, ever so slowly, into rougher and darker bumps that we don't want there. Your dermatologist has lots of solutions to rid you of these, but when you mention that you don't like them, what is the response?

"Oh, yes, I see. Yes, it's a benign growth but Medicare won't pay for it." Ah, ha, Medicare won't pay for it and it is dismissed as a useless bit of leftover vanity. You should be content that it's not cancer (which Medicare would pay for) and go off into your twilight years accumulating ever more bumps or seeing them darken. Is that okay? Should you not want to have them removed early before they make you feel like the Wicked Witch of the West's older sister?

What about removal? Again, it is seen with a bit of hummming and you are told it's really not too noticeable. But to you they're noticeable and you want action early, right? Why are your concerns dismissed? Oh, right, you're in the Medicare group so you should only have what's able to be coded and paid for.

Proton therapy will pay thousands of dollars each year for treatments, or so I've read, that aren't very useful, if useful at all. But ugly bumps that you want removed, at minimal cost, must be endured as a sign that you are in your senescence. Yes, that's a derivative of senile and isn't that a wonderful thing to carry around like a badge that says soon your memory will go, too. They'll give you useless medication for that and Medicare will pay for it.

Does wanting to look good contribute anything to anyone? You bet your boots it does. Follow the script to its inevitable conclusion and you will see that not looking good diminishes your feelings about yourself, may lead to anxiety and depression and what does that mean? Why medication, of course, which may cause further problems in your health, but they'll all be paid for by Medicare. So, isn't it reasonable to stop the march toward enormous payments by the simple removal of these crusty spots early for $25 or so before you go on to hundreds of dollars for medications and treatments by internists or psychiatrists. Where is the sense in all of it?

Would you run your car without transmission fluid or oil until it began to burn out so that you'd have to replace either the transmission or the motor? No, of course, you wouldn't. Then why should you not take the normal steps of maintenance in skin care that surely leads down a dismal road in medicine? What's wrong with a certain amount of vanity? Doesn't the Medicare generation have a right to feel good about themselves and go to more social events than physician's visits?

Then, turn your attention to your Medicare-eligible age again and see how your medical concerns are tossed aside. You forgot a word or what you did for lunch last week? Oh, oh, must be oncoming Alzheimer's and maybe we should treat that. Did you know that the first medication for Alzheimer's was one originally used during the turn of the 20th Century to treat intestinal parasites, aka worms? Yes, and it didn't work well at all. The treatment, in fact, had some pretty disturbing consequences, but it as a treatment for a medically recognized disease that will crush our economy if we don't defeat it. But small spots on your skin that will grow and grow and eat away at your self-esteem? Oh, that's just in your mind and you have to get used to it. We'll give you an antidepressant for that.

Jackie Kennedy, or so I was told in a physician's office, had her face done several times and we hold her as the epitome of American style, grace and beauty. But wasn't she in her senescence? Sure, she could afford to pay to have those disturbing growth of ageing removed and the skin on her neck and face pulled up. Medicare doesn't pay for face jobs but it pays for a lot more expensive treatments because there's "coding" for that. The magic word here, of course, is coding and if a doc can't code it, you will probably be seen as not being able to afford it because you're Medicare-eligible. How demeaning and elitist.

What happened to helping medical professionals become more compassionate when someone is over 60? What's wrong with not aging gracefully and wanting to look good? Don't they want to look good? Of course, this group (growing exponentially as it is) is left to be victimized by charlatans in white coats on TV who hawk products that "shrink" wrinkles and leave skin smooth for a mere $49.95 a month for the rest of your life. Look at the women they use as examples. And what did those women have done before they went in front of the camera? Yes, face jobs.

We pay an enormous price in terms of human dignity by our foolish attitudes regarding our older Americans who we relegate to scratching for every bit of self-esteem that they can muster--as the professionals tear it down with cruel words. For shame.