Published Online: Saturday, June 1, 2002

The 1978 novel The House of God popularized the term gomer for a patient who should ?get out of my emergency room!? The gomer was often an elderly patient, and one of the ?laws? of the book was that ?gomers go to ground,? referring to their tendency to fall or fall out of bed.

Unfortunately, according to a recent Johns Hopkins study report, this fictional attitude toward the elderly among medical students has some real-world roots. The survey concludes that most medical students generally have a poor knowledge and understanding of the elderly, which may translate to inferior care for older patients.

Students were more likely to rate an old person as ?ineffective? and were less likely to recommend aggressive treatment for elderly patients. For example, 83% of students said that, if they saw a 10-year-old girl with pneumonia in both lungs, they would admit the child to the intensive care unit and treat her pneumonia aggressively. When the patient?s age was changed to 85, however, only 56% recommended an aggressive course of treatment.

According to the report, ?these data suggest that medical students have negative attitudes toward and limited knowledge about older persons at the start of their medical school experience.? The report suggests more training in geriatrics for medical students, but it notes that changing attitudes will take time.

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