Becker's Clinical Quality & Infection Control

17 PATIENT EXPERIENCE How medical schools are battling stereotypes about elderly patients By Megan Knowles M edical schools across the U.S. are implementing programs to intro- duce students to healthy, active elders in an effort to ensure medical students have an accurate perception of these patients, according to e New York Times. Here are five report insights: 1. Ronald Adelman, MD, co-chief of geriat- rics at Weill Cornell Medicine in New York City, developed an annual program where healthy seniors share their perspectives, including a theater piece, aer he realized medical students were getting a distorted view of older adults. e program is re- quired for all second-year medical students. "Unfortunately, most education takes place within the hospital," Dr. Adelman said. "If you're only seeing the hospitalized elderly, you're seeing the debilitated, the physically deteriorating, the demented. It's easy to pick up ageist stereotypes." 2. Ageist stereotypes can influence how physicians provide care. One patient, 88-year-old Marcia Levine, told students about a gastroenterologist who dismissed her complaints of fatigue by saying, "At your age, you can't expect to have much energy." Aer switching physicians, Ms. Levine learned she had a low-grade infection. 3. At least 20 U.S. medical schools are mak- ing similar efforts to introduce students to active and healthy elders, said Amit Shah, MD, a geriatrician who helps direct the Senior Sages program at the Mayo Clinic School of Medicine in Rochester, Minn. 4. e programs vary in form, from Weill Cornell's two-hour introduction to a se- mester-long curriculum at the University of North Carolina School of Medicine in Chapel Hill. Schools, including the Medical University of South Carolina in Charleston and the Icahn School of Medicine at Mount Sinai in New York City, match students with older patients whom they follow throughout their four-year educations. e students make home visits, join their senior mentors on medical appointments and visit them if they become hospitalized. 5. ese efforts can be voluntary or man- datory and can emphasize clinical skills or encourage new perspectives. Although there are relatively few of these initiatives in U.S. medical schools, leaders can consider launching these programs, as they are inex- pensive, and older patients are enthusiastic about participating. One patient who participated in Weill Cornell's program said she appreciated that the students had listened, calling the session "a gi to us, as well as to them. It's an acknowledgment that we are important and of interest." n Why Boston patients have longer appointment wait times By Megan Knowles B oston residents often struggle to schedule med- ical appointments, even though the city has one of the highest per-capita rates of physicians and houses some of the country's best hospitals, Boston Magazine reported. Here are four things to know: 1. A new patient in Boston can expect to wait more than 52 days before seeing a physician, according to a 2017 Mer- ritt Hawkins study cited by Boston Magazine. Boston's wait times are longer than those in 14 other major U.S. cities, including New York, Los Angeles and Philadelphia. 2. "Boston should have it right, and we don't," said Ateev Mehrotra, MD, an associate professor of healthcare policy and medicine at Boston-based Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center. "You would think if there was a city where the wait time was the lowest, it would be here." But the city's top healthcare providers may make wait times worse since they juggle hospital appointments, academic teaching loads and research projects. The city is also a destination for foreign travelers looking for high-quality care. 3. Technology developments may help improve long wait times. Although Boston's providers use the latest medical technology during treatment, they can update how they engage with patients, said Susan Dentzer, president and CEO of Network for Excellence in Health Innovation, which is based in Boston. Telemedicine could help in-office wait times, but restrictive telemedicine policies in Massachusetts mean insurance does not always pay for virtual visits, and offices have been slow to offer them. 4. Boston's technology sector is working on other low-cost solutions. The locally based app company Amwell provides patients virtual appointments with primary care physicians and specialists starting at $69 before insurance. Another company, UberDoc, connects patients with specialists in the Boston area for a flat fee of $300 per appointment. "We have a healthcare system that provides Star Wars medicine on a Flintstones delivery platform," Ms. Dentzer said. "We need to at least move up to The Jetsons." n

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