Geriatrics is a field of investigation. To solve medical mysteries, physicians must become detectives and unravel the effects of overlapping causes, such as chronic disease, acute injury, social factors, and the normal aging process. This is a challenge that tests the patience of many physicians. The number of board-certified geriatricians in the U.S. currently stands at just over 7,000, but has been declining since 2017.
Dr. Clara Tsui, a geriatrician at St. Paul's Hospital in Vancouver, British Columbia, says the term “failure to thrive” masquerades as a diagnosis and shortens the investigation process before doctors can determine the true cause. said it would be discontinued. Last month, she saw the label listed in the medical records of an 82-year-old man with Alzheimer's disease who had fallen and hit his head. Despite brain scans showing internal bleeding, the man was only diagnosed with “failure to thrive,” which is “not a diagnosis at all,” Tsui said.
Dr. Martha Spencer, a geriatrician and colleague of Dr. Tsui's at St. Paul's University, called the term ambiguous, demeaning and ageist. “I wonder why it's lasted so long,” she says.
In 2020, Dr. Spencer and Dr. Tsui led a study that found that older patients who were labeled as “failure to thrive” had significantly longer wait times to be admitted to hospital. Once admitted to the hospital, these patients are known to have longer hospital stays and an increased risk of infection and other complications. By the time these patients were released, most (88%) had a specific diagnosis, such as kidney failure or severe dehydration.
In other words, the authors concluded that the label “failure” tends to mask treatable disease and burdens patients with unnecessary delays in treatment. A diagnosis of “failure” can become a self-fulfilling prophecy, leading doctors to believe they are just another elderly patient on the path to inevitable decline. (Similarly, researchers found that “acopia,” a fancy medical term that literally means “not to deal with,” is still sometimes used in the UK and Australia, leading doctors to often overlook acute illnesses.) did.)