Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T19:07:39.230Z Has data issue: false hasContentIssue false
  • English
  • Français

‘My opinion is that doctors prefer younger people’: older women, physicians and ageism

Published online by Cambridge University Press:  02 November 2016

HAZEL MACRAE
HAZEL MACRAE*
Affiliation:
Department of Sociology and Anthropology, Mount Saint Vincent University, Halifax, Canada.
*
Address for correspondence: Hazel MacRae, Department of Sociology and Anthropology, Mount Saint Vincent University, Halifax, Nova Scotia, B3M 2J6, Canada E-mail: Hazel.MacRae@msvu.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

This study examines older women's views about and subjective experience of ageism during interactions with physicians. Views about and experience of sexism are also examined. Data were obtained from in-depth, face-to-face interviews conducted with 36 Canadian women 55 years and older. The findings indicate that older women believe ageism is likely to occur during medical encounters and are concerned about it. Few, however, claim to have personally experienced it. Contradicting the stereotype of the passive older patient, many participants were employing strategies to avoid becoming targets of ageism. Although there was some concern about sexism during medical encounters, in general, the women appeared to be less conscious of sexism than ageism.

Keywords

ageismolder womenphysicianssexism
Type
Articles
Information
Ageing & Society , Volume 38 , Issue 2 , February 2018 , pp. 240 - 266
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, R., Price, G., Tucker, G., Nguyen, A. and Wilson, D. 2012. The doctor and the patient – how is the clinical encounter perceived? Patient Education and Counseling, 86, 1, 127–33.Google Scholar
Adams, W., McIlvain, H., Lacy, N., Magsi, H., Crabtree, B., Yenny, S. and Sitorius, A. 2002. Primary care for elderly people: why do doctors find it so hard? The Gerontologist, 42, 6, 835–42.Google Scholar
Adelman, R. D., Greene, M. G. and Charon, R. 1991. Issues in physician–elderly patient interaction. Ageing & Society, 11, 2, 127–48.Google Scholar
Adler, S., McGraw, S. A. and McKinlay, J. B. 1998. Patient assertiveness in ethnically diverse older women with breast cancer: challenging stereotypes of the elderly. Journal of Aging Studies, 12, 4, 331–50.CrossRefGoogle Scholar
Angus, J. and Reeve, P. 2006. Ageism: a threat to ‘aging well’ in the 21st century. Journal of Applied Gerontology, 25, 2, 137–52.Google Scholar
Armstrong, P. 2006. Gender, health, and care. In Raphael, D., Bryant, T. and Rioux, M. (eds), Staying Alive: Critical Perspectives on Health, Illness, and Health Care. Canadian Scholars Press, Toronto, 287–303.Google Scholar
Bastiaens, H., Van Royen, P., Pavlic, D. R., Raposo, V. and Baker, R. 2007. Older people's preferences for involvement in their own care: a qualitative study in primary care in 11 European countries. Patient Education and Counseling, 68, 1, 33–42.Google Scholar
Beisecker, A. E. 1996. Older person's medical encounters and their outcomes. Research on Aging, 18, 1, 9–31.Google Scholar
Bennet, T. and Gaines, J. 2010. Believing what you hear: the impact of aging stereotypes upon the old. Educational Gerontology, 36, 5, 435–45.Google Scholar
Bertakis, K. D. and Azari, R. 2012. Patient-centered care: the influence of patient and resident physician gender and gender concordance in primary care. Journal of Women's Health, 21, 3, 326–33.CrossRefGoogle ScholarPubMed
Binstock, R. H. 2005. Old-age policies, politics, and ageism. Generations, 29, 3, 73–8.Google Scholar
Black, D. 2000. Editorial: complaints, doctors, and older people. Age and Ageing, 29, 5, 389–91.Google Scholar
Blumer, H. 1969. Symbolic Interactionism: Perspective and Method. Prentice Hall, Upper Saddle River, New Jersey.Google Scholar
Burroughs, H., Lovell, K., Morley, M., Baldwin, R., Burns, A. and Chew-Graham, C. 2006. ‘Justifiable depression’: how primary care professionals and patients view late-life depression? A qualitative study. Family Practice, 23, 3, 369–77.Google Scholar
Butler, R. N. 2005. Foreword. In Palmore, E. B., Branch, L. and Harris, D. K. (eds), Encyclopedia of Ageism. The Haworth Press, New York, xv–xvi.Google Scholar
Butler, R. N. 1969. Age-ism: another form of bigotry. The Gerontologist, 9, 4, 243–6.Google Scholar
Bylund, C. L. and Makoul, G. 2002. Empathetic communication and gender in the physician–patient encounter. Patient Education and Counseling, 48, 3, 207–16.Google Scholar
Calasanti, T. M. 2008. Theorizing feminist gerontology, sexuality, and beyond: an intersectional approach. In Bengston, V., Gans, D. and Putney, A. (eds), Handbook of Theories of Aging. Springer, New York, 471–85.Google Scholar
Calasanti, T. M. and Slevin, K. F. 2006. Age Matters: Realigning Feminist Thinking. Routledge, New York.Google Scholar
Calasanti, T. M., Slevin, K. F. and King, N. 2006. Ageism and feminism: from ‘et cetera’ to center. NWSA Journal, 18, 1, 13–30.Google Scholar
Campbell, C. and McGauley, G. 2005. Doctor–patient relationships in chronic illness: insights from forensic psychiatry. British Medical Journal, 330, 7492, 667–70.Google Scholar
Charmaz, K. 2006. Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Sage, Thousand Oaks, California.Google Scholar
Cherubini, A., Corsonello, A. and Lattanzio, F. 2012. Underprescription of beneficial medicines in older people. Drugs & Aging, 29, 6, 463–75.CrossRefGoogle ScholarPubMed
Coffey, A. and Atkinson, P. 1996. Making Sense of Qualitative Data. Sage, Thousand Oaks, California.Google Scholar
Cuddy, A. J. C., Norton, M. I. and Fiske, S. 2005. This old stereotype: the pervasiveness and persistence of the elderly stereotype. Journal of Social Issues, 61, 2, 267–85.Google Scholar
Currie, J. 2003. Manufacturing Addiction: The Overprescription of Benzodiazepines and Sleeping Pills to Women in Canada. BC Centre of Excellence for Women's Health, Vancouver, Canada.Google Scholar
Evans, K. and Robertson, S. R. 2009. ‘Dr. Right’: elderly women in pursuit of negotiated health care and mutual decision-making. The Qualitative Report, 14, 3, 409–32.Google Scholar
Feldman, D. E., Huynh, T., Des Lauriers, J., Giannetti, N., Frenette, M., Grondin, F., Michel, C., Sheppard, R., Montigny, M., Lepage, S., Nguyen, V., Behlouli, H., Pilote, L. 2013. Gender and other disparities in referral to specialized heart failure clinics following emergency department visits. Journal of Women's Health, 22, 6, 526–31.Google Scholar
Freidson, E. 1989. Medical Work in America. Yale University Press, New Haven, Connecticut.Google Scholar
Glaser, B. G. and Strauss, A. 1967. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine De Gruyter, New York.Google Scholar
Gochfeld, M. 2010. Sex-gender research sensitivity and healthcare disparities. Journal of Women's Health, 19, 2, 189–94.Google Scholar
Godfrey, J. R. and Nelson, D. T. 2008. Toward optimal health: managing arthritis in women. Journal of Women's Health, 17, 5, 729–34.Google Scholar
Goffman, E. 1959. The Presentation of Self in Everyday Life. Doubleday & Company, New York.Google Scholar
Greaves, L. 2009. Women, gender, and health research. In Armstrong, P. and Deadman, J. (eds), Women's Health: Intersections of Policy, Research, and Practice. Women's Press, Toronto, 3–34.Google Scholar
Greene, M. G. and Adelman, R. D. 2003. Physician–older patient communication about cancer. Patient Education and Counseling, 50, 1, 55–60.Google Scholar
Greene, M. G., Adelman, R., Charon, R. and Hoffman, S. 1986. Ageism in the medical encounter: an explanatory study of the doctor–elderly patient relationship. Language & Communication, 6, 1/2, 113–24.Google Scholar
Greene, M. G., Hoffman, S., Charon, R. and Adelman, R. D. 1987. Psychosocial concerns in the medical encounter: a comparison of the interactions of doctors with their old and young patients. The Gerontologist, 27, 2, 164–68.CrossRefGoogle ScholarPubMed
Gustafson, D. L. 2005. Understanding women and health. In Mandell, N. (ed.), Feminist Issues: Race, Class, and Sexuality. Prentice Hall, Toronto, 266–86.Google Scholar
Hahn, S. 2001. Physical symptoms and physician-experienced difficulty in the physician-patient relationship. Annals of Internal Medicine, 134, 9 Part 2, 897–905.CrossRefGoogle ScholarPubMed
Henderson, J. W. 1997. Issues in the medical treatment of elderly women. Journal of Women and Aging, 9, 1/2, 107–15.CrossRefGoogle Scholar
Hewitt, J. P. 1991. Self and Society: A Symbolic Interactionist Social Psychology. Allyn and Bacon, Boston.Google Scholar
Higashi, R. T., Tillack, A. A., Steinman, M., Harper, M. and Johnston, C. B. 2012. Elder care as ‘frustrating’ and ‘boring’: understanding the persistence of negative attitudes toward older patients among physicians-in-training. Journal of Aging Studies, 26, 4, 476–83.Google Scholar
Hori, S. 1994. Beginning of old age in Japan and age norms in adulthood. Educational Gerontology, 20, 5, 439–51.Google Scholar
Hummert, M. L., Garstka, T. A. and Shaner, J. L. 1997. Stereotyping of older adults: the role of target facial cues and perceiver characteristics. Psychology and Aging, 12, 1, 107–14.Google Scholar
Hurd Clarke, L. and Griffin, M. 2008. Visible and invisible ageing: beauty work as a response to ageism. Ageing & Society, 28, 5, 653–74.Google Scholar
Hurd Clarke, L., Bennett, E. V. and Korotchenko, A. 2014. Negotiating vulnerabilities: how older adults with multiple chronic conditions interact with physicians. Canadian Journal on Aging, 33, 1, 26–37.Google Scholar
Kane, R. L. and Kane, R. A. 2005. Ageism in healthcare and long-term care. Generations, 29, 3, 49–54.Google Scholar
Kite, M. E. and Wagner, L. S. 2002. Attitudes toward adults. In Nelson, T. (ed.), Ageism: Stereotyping and Prejudice Against Older Persons. The MIT Press, Cambridge, Massachusetts, 129–61.Google Scholar
Koenig, H. G. 2007. Physician attitudes toward treatment of depression in older medical inpatients. Aging & Mental Health, 11, 2, 197–204.CrossRefGoogle ScholarPubMed
Liang, W., Kasman, D., Wang, J. H., Yuan, E. H. and Mandelblatt, J. S. 2006. Communication between older women and physicians: preliminary implications for satisfaction and intention to have mammography. Patient Education and Counseling, 64, 1–3, 387–92.Google Scholar
Lofland, J. and Lofland, L. H. 1995. Analyzing Social Settings: A Guide to Qualitative Observation and Analysis. Wadsworth, Belmont, California.Google Scholar
MacRae, H. 2015. Not too old, not too young: older women's perceptions of physicians. Canadian Journal on Aging, 34, 4, 545–60.CrossRefGoogle Scholar
Malatesta, V. J. 2007. Introduction: the need to address older women's mental health issues. Journal of Women & Aging, 19, 1/2, 1–12.CrossRefGoogle ScholarPubMed
Maly, R. C., Leake, B. and Sillman, R. 2004. Breast cancer treatment in older women: impact of the patient–physician interaction. Journal of the American Geriatrics Society, 52, 7, 1138–45.Google Scholar
Marshall, C. and Rossman, G. H. 2011. Designing Qualitative Research. Sage, Thousand Oaks, California.Google Scholar
May, C., Rapley, T., Moreira, T., Finch, T. and Heaven, B. 2006. Technogoverance: evidence, subjectivity, and the clinical encounter in primary care medicine. Social Science & Medicine, 62, 4, 1022–30.Google Scholar
McCandless, N. J. and Conner, F. P. 1999. Older women and the health care system: a time for change. In Garner, D. (ed.), Fundamentals of Feminist Gerontology. The Haworth Press, New York, 13–27.Google Scholar
McDaniel, S. 2001. A sociological perspective on women and aging as the millennium turns. In Garner, J. D. and Mercer, S. O. (eds), Women as They Age. The Haworth Press, New York, 33–47.Google Scholar
Mead, G. H. 1934. Mind, Self, and Society. University of Chicago Press, Chicago.Google Scholar
Meisner, B. A. 2012. Physicians’ attitudes toward aging, the aged, and the provision of geriatric care: a systematic narrative review. Critical Public Health, 22, 1, 61–72.Google Scholar
Nicolai, J. and Demmel, R. 2007. The impact of gender stereotypes on the evaluation of general practitioners’ communication skills: an experimental study using transcripts of physician–patient encounters. Patient Education and Counseling, 69, 1–3, 200–5.CrossRefGoogle ScholarPubMed
Noori, K. and Weseley, A. J. 2011. Beyond credentials: the effect of physician sex and speciality on how physicians are perceived. Current Psychology, 30, 3, 275–83.Google Scholar
Nusbaum, N. R. H., Singh, A. R. and Pyles, A. A. 2004. Sexual health needs of women aged 65 and older. Journal of the American Geriatrics Society, 52, 1, 117–22.Google Scholar
Nussbaum, J. F., Pitts, M. J., Huber, F. N., Raup Krieger, J. L. and Ohs, J. E. 2005. Ageism and ageist language across the life span: intimate relationships and non-intimate interactions. Journal of Social Issues, 61, 2, 287–305.Google Scholar
Palmore, E. B. 1990. Ageism: Negative and Positive. Springer, New York.Google Scholar
Palmore, E. B. 2005. Health care. In Palmore, E. B., Branch, L. and Harris, D. K. (eds), Encyclopedia of Ageism. The Haworth Press, New York, 166–8.Google Scholar
Pasupathi, M. and Lockenhoff, C. E. 2005. Ageist behavior. In Nelson, T. (ed.), Stereotyping and Prejudice Against Older Persons. The MIT Press, Cambridge, Massachusetts, 201–46.Google Scholar
Poot, A. J., den Elzen, W. P. J., Blom, J. W. and Gussekloo, J. 2014. Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems. PLoS ONE, 9, 4,1–5.Google Scholar
Pritchard, K. I. 2007. Editorial: have we been guilty of ageism in the primary treatment of breast cancer? British Journal of Cancer, 96, 7, 1011–2.Google Scholar
Prus, R. 1999. Beyond the Power Mystique: Power as Intersubjective Accomplishment. State University of New York Press, Albany.Google Scholar
Radecki, S. E., Kane, R. L., Soloman, D. H., Mendenhall, R. C. and Beck, J. C. 1998. Do physicians spend less time with older patients? Journal of the American Geriatrics Society, 36, 8, 713–8.CrossRefGoogle Scholar
Remmes, K. R. and Levy, B. R. 2005. Medical students. In Palmore, E. B., Branch, L. and Harris, D. K. (eds), Encyclopedia of Ageism. The Haworth Press, New York, 217–20.Google Scholar
Rodeheaver, D. and Datan, N. 1988. The challenge of double jeopardy: toward a mental health agenda for aging women. American Psychologist, 43, 8, 648–54.Google Scholar
Rodwin, M. A. 1994. Patient accountability and quality of care: lessons from medical consumerism and the patients’ rights, women's health and disability rights movements. American Journal of Law & Medicine, xx, 1/2, 147–67.Google Scholar
Roter, D. L. and Hall, J. A. 2004. Physician gender and patient-centered communication: a critical review of empirical research. Annual Review of Public Health, 25, 1, 497–519.Google Scholar
Rozanova, J., Northcott, H. C. and McDaniel, S. A. 2006. Seniors and portrayals of intra- generational and inter-generational inequality in The Globe and Mail . Canadian Journal on Aging, 25, 4, 373–86.Google Scholar
Rubin, H. J. and Rubin, I. S. 1995. Qualitative Interviewing: The Art of Hearing Data. Sage, Thousand Oaks, California.Google Scholar
Sharpe, P. A. 1995. Older women and health services: moving from ageism toward empowerment. Women & Health, 22, 3, 9–23.Google Scholar
Shaw, R. and Ogden, J. 2006. What's in a face? The role of doctor ethnicity, age and gender in the formation of patients’ judgements: an experimental study. Patient Education and Counseling, 60, 2, 136–41.Google Scholar
Sidell, M. 1992. The relationship of elderly women to their doctors. In George, J. and Ebrahim, S. (eds), Health Care for Older Women. Oxford University Press, Oxford, 179–96.Google Scholar
Sifer-Riviere, L., Girre, V., Gisselbrecht, M. and Saint-Jean, O. 2010. Physicians’ perceptions of cancer care for elderly patients: a qualitative sociological study based on a pilot geriatric oncology program. Critical Reviews in Oncology/Hematology, 75, 1, 58–69.Google Scholar
Silliman, R. A. 2009. When cancer in older adults is undermanaged: the breast cancer story. Journal of the American Geriatrics Society, 57, supplement 2, Ps259–61.Google Scholar
Sontag, S. 1972. The double standard of aging. Saturday Review of The Society, 23, 1, 29–38.Google Scholar
Tannenbaum, C. and Mayo, N. 2003. Women's health priorities and perceptions of care: a survey to identify opportunities for improving preventative health care delivery for older women. Age and Ageing, 32, 6, 626–35.Google Scholar
Tannenbaum, C., Nasmith, L. and Mayo, N. 2003. Understanding older women's health care concerns: a qualitative study. Journal of Women & Aging, 15, 1, 3–16.Google Scholar
Todd, A. D. 1989. Intimate Adversaries: Cultural Conflict Between Doctors and Women Patients. University of Pennsylvania Press, Philadelphia.Google Scholar
Van den Hoonard, W. C. 1997. Working with Sensitizing Concepts: Analytical Field Research. Sage, Thousand Oaks, California.Google Scholar
Van Til, L., MacQuarrie, C. and Herbert, R. 2003. Understanding barriers to cervical cancer screening among older women. Qualitative Health Research, 13, 8, 1116–31.Google Scholar
Walter, U., Flick, U., Neuber, A., Fischer, C., Hussein, R. J. and Schwartz, F. W. 2010. Putting prevention into practice: qualitative study of factors that inhibit and promote preventive care by general practitioners, with a focus on elderly patients. BMC Family Practice, 11, 68–78.Google Scholar
Weitzman, P. F. and Weitzman, E. A. 2003. Promoting communication with older adults: protocols for resolving interpersonal conflicts and for enhancing interactions with doctors. Clinical Psychology Review, 23, 4, 523–35.Google Scholar
Wilkinson, J. and Ferraro, K. F. 2002. Thirty years of ageism research. In Nelson, T. D. (ed.), Ageism: Stereotyping and Prejudice Against Older Persons. The MIT Press, Cambridge, Massachusetts, 339–58.Google Scholar
Zeplin, H., Sills, R. A. and Heath, M. W. 1987. Is age becoming irrelevant? International Journal of Aging & Human Development, 24, 4, 241–56.Google Scholar