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Ageism in health care? Yep, it’s a thing.

Caring for baby boomers in the ER ought to mean more than asking demeaning questions.

Hopp-Bruce/Globe staff; Adobe

They are the near-divine beings in white coats or scrubs — until that moment when they are revealed as subject to the same human flaws as the rest of us.

So come June 1, all doctors in the state will be required to take two hours of training to “address implicit bias” because, as the Board of Registration in Medicine noted when it voted on the new requirement, “implicit bias among health care providers is one factor that perpetuates” racial and ethnic inequities that lead to health disparities.

No argument there. There’s a serious body of evidence that, for example, doctors are slower to diagnose appendicitis in Black children than in white children. Or that non-white patients get lower doses of pain medications.


But allow me to suggest an addition to that implicit bias list: age.

Ageism can be every bit as demeaning and dehumanizing as any other “ism” when it comes to the delivery of health care, and potentially as dangerous.

Sure there are studies to confirm that too. But better yet, just spend five hours in a hospital emergency room waiting to confirm a broken collarbone — the result of an unfortunate encounter between Big Girl shoes (rediscovered after a two-year hiatus) and a Back Bay brick sidewalk.

It matters not that the day before I had a glorious four-mile run along the Charles, a repeat of one just like it the day before that. In the emergency room, I was only a date of birth, and the DOB had obviously qualified me for the realm of the aged — a realm peppered with repeated inquiries about my mental state, my living environment, and whether I had hit my head.

Of course, I should not have been taking up valuable time and space in the ER in the first place, but when a call to my primary care physician netted no urgent-care slots that day, I was between the rock and the hard place of health care.


How bad could it be, dealing with a bunch of strangers in the ER whose sole preoccupation was my age rather than my collarbone?

There was the whole line of inquiry by a nurse, who surely had better things to do, into whether I had “help at home.”

Did she mean my cleaning woman or was she thinking “Downton Abbey” and that I had just given the butler and the cook the day off and popped into the ER for a quick cuppa tea?

“Oh, I don’t think these apply to you,” she said as she continued to type feverously into the computer, but persisted in asking the questions anyway — mostly about whether I had “help” to dress or bathe or feed me.

Not one, but two social workers came by sequentially to make similar inquiries as I tried to assure them, no, I’m not in the habit of falling, I didn’t hit my head, and I’m not suicidal (although increasingly grumpy), and I just need an X-ray.

I finally made my last-ditch appeal to Social Worker #2, telling her that Tuesday is a writing day and I really needed to get back to work.

It was a none too subtle way of saying, hey, focus on something other than my DOB. I have a career. I have a life. I do not fit neatly into your computer-generated list of insufferable questions. And don’t put me in one of your little boxes that simply says “old” and think you’ve done your job.


And just as implicit bias in race and ethnicity have health care consequences, so does ageism. Ageism can lead to costly overtreatment of illnesses by physicians, a cost estimated at between $158 billion to $226 billion every year. But just as important, this trial by health care ultimately makes older patients less likely to seek treatment.

Would I be less likely to seek help in the ER again? Short of suffering a gunshot wound, you bet I would.

The notion of caring for an enormous cohort of aging baby boomers continues to strike terror in the hearts of the health care world, “as society copes with this unprecedented demographic shift,” as an article in Kaiser Health News put it.

That terror manifests itself every day in doctor’s offices and emergency rooms — and not in a good way. A little common sense and a healthy dose of respect might just be the prescription the system needs.

Rachelle G. Cohen is a Globe opinion writer. She can be reached at rachelle.cohen@globe.com.