Disability must be among topics of implicit bias
Re “Is the patient scary, or just a man like your uncle?” (Page A1, April 23): Implicit bias training for physicians around race and gender is sorely needed, but the absence of disability from the list of topics is a glaring omission. A 2021 study by Dr. Lisa Iezzoni, of Massachusetts General Hospital, et al., found more than 80 percent of physicians believe people with disabilities have an inherently lower quality of life, while less than 41 percent were “very confident” they provided the same quality of care to their disabled patients as their nondisabled ones.
During the COVID-19 pandemic, this bias has had horrible and even deadly consequences, such as a father of five, Michael Hickson, being removed from life support despite his wife’s objections. At a legislative hearing earlier in November 2021, people shared stories of being angrily urged to sign do-not-resuscitate orders, and seeing their loved ones sent home from hospitals to die in order to clear up beds.
Passing a measure pending in the Legislature that would prevent discrimination against people with disabilities in the provision of health care would go a long way toward protecting people with disabilities from this bias, but we also need training for physicians to change the way they see our community.
Disability Policy Consortium
Medical ageism is common
It is curious that the new anti-bias courses of the Board of Registration in Medicine are limited to attitudes toward “gender, race, ethnicity, and culture,” but not age. Medical ageism is common. It starts with not talking to an older adult patient who comes accompanied by a younger person. It affects treatment decisions (“This is just aging,” so the condition is not treatable). Geriatrics is among the least-well-paid specialties, and newly fledged doctors avoid it also because old people are “scary,” that is, they may have comorbidities that make proper treatment difficult.
Given that about 10,000 people a day enroll in Medicare, a country that refuses to fight bias against old people is damning everyone eventually to unequal, poorer care.
Margaret M. Gullette
The writer is the author of “Ending Ageism, or How Not to Shoot Old People.”