A new study by a team from the University of Michigan Institute for Healthcare Policy and Innovation shows that adults over age 50 place more importance on convenience-related factors, rather than reputation, when choosing a doctor.
The study, based on data from IHPI’s National Poll on Healthy Aging supported by AARP and Michigan Medicine, still shows that online ratings and reviews of physicians play an important role, and should receive attention from providers and policymakers.
Dr. Jeffrey Kullgren, a U-M primary care physician and lead author of the study, describes the findings.
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When asked how likely they would be to get a COVID-19 vaccine when available and if no cost to them, 58% of older adults indicated they would be likely to get a COVID-19 vaccine (33% very likely, 25% somewhat likely), 28% said they were unlikely (11% somewhat unlikely, 17% very unlikely), and 14% were unsure or did not know.
About two in three older adults (63%) indicated they received a flu shot last flu season. Seven in ten either received one since August 2020 (34%) or intended to get one this flu season (38%). Nearly half of adults age 50–80 (49%) believed that getting a flu vaccine is more important this year compared to other years, 44% said it is just as important, and 7% said it was less important.
Interest in getting a COVID-19 vaccine was more common among those age 65–80 compared with those 50–64 (63% vs. 54%), men compared with women (64% vs. 52%), and Whites compared with Hispanics and Blacks (63% vs. 51% vs. 40%). Individuals who lived with others, had higher household incomes, or had more education were also more likely to report they would get a COVID vaccine.
Half of adults age 50–80 (52%) said they personally knew someone who had COVID-19, and 2% reported having had it themselves. One in five older adults (19%) indicated they personally knew someone who died from COVID-19. The likelihood of getting a COVID-19 vaccine did not differ based on whether respondents knew someone who had COVID-19 or who died from it.
In deciding whether to get a COVID-19 vaccine, older adults rated the following as very important: how well it works (80%), their own research (56%), and if it was recommended by their doctor (52%), public health officials (42%), or family and friends (13%). Cost was rated as very important by 30% of older adults.
I described another option to Grandpa: he could voluntarily stop eating and drinking. He’d never considered this possibility (which reminded me again how one’s family members and clinicians contribute to inequities in end-of-life care). The option intrigued Grandpa, and during subsequent visits he reinforced his plan to pursue it. I insisted that he first move into my home. I wanted to ensure the quality of his care, knowing that I could enroll him in my health system’s hospice program. But I also wished to test his resolve, reasoning that his mind might change once his isolation ended.
For a month after he entered our home, his spirits were brighter, his gait steadier, and his appetite heartier. He joined my wife, two daughters, and me for dinner each night, typically preceded by a vodka martini that I had stirred for him — a daily pleasure he’d allowed himself for 80 years and had missed as a facility resident. He’d tell stories of the Navy, his career, and his family history and would regularly quip, “If you keep treating me this well, I might just stick around a while longer!”
But eventually he returned to his goal of hastening death. One night, he said he was ready to stop eating and drinking the next morning, but when morning came, he asked for his usual coffee and bagel. He confided that he was scared. When I asked of what, he replied, “It’s like trying to roller skate. I’m scared of starting. Though I know that once I do, I’ll probably roll.”
This poll examined older adults’ experiences with nine forms of everyday ageism. These forms were categorized into three groups: (1) exposure to ageist messages, (2) ageism in interpersonal interactions, and (3) internalized ageism (personally held beliefs
about aging and older people).
“There’s an aging population, and there’s a lot of skin out there,” said Dr. Isaacs. “One in five people in the country develop skin cancer, but there is a plethora of benign skin conditions that also require the expertise of the dermatologist. So, you have increasing demand and a limited supply of dermatologists.”
A basic example of how the TPMG teledermatology program works involves a patient who is concerned about a suspicious lesion or mole on their body. The patient can take a picture of the location in question and send it to their primary care physician for review. The physician can request the patient come in for a more thorough evaluation, or if the physician determines that a dermatologist should be involved, they can send the photo to an on-call dermatologist to review.
If the patient does an in-person evaluation, the physician can also take a higher-quality image and forward that to a dermatologist. The dermatologist can then decide whether there is a problem, if a prescription is needed, or if there should be an in-person evaluation and potential biopsy.
A study in the Journal of the American Academy of Dermatology in 2019 found that when TPMG dermatologists had the chance to look at well-photographed skin lesions, they were able to identify nearly 10% more cancers with almost 40% fewer referrals to the dermatology department.
We observed that increased adherence to the MedDiet modulates specific components of the gut microbiota that were associated with a reduction in risk of frailty, improved cognitive function and reduced inflammatory status.
Dr Philip Smith, Digital and Education Editor of Gut and Consultant Gastroenterologist at the Royal Liverpool Hospital interviews Professor Paul O’Toole; who is Professor of Microbial Genomics, Head of School of Microbiology and Principal Investigator in APC Microbiome Ireland, an SFI funded centre at University College Cork, Ireland, on “Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across 5 European countries” published in paper copy in Gut in July 2020.
Presented by Sarah Dulaney, RN, CNS, a nurse at the UCSF Memory and Aging Center, and Helen Medsger, a family caregiver and LBD support group leader, as part of the Lewy Body Dementia Caregiver Webinar Series supported by the UCSF Memory and Aging Center and the Administration for Community Living.