Patient symptoms and physician prescribing patterns in the elderly

The aim was to determine if different doctors prescribed differently for older patients with the same diagnoses as patients who were younger. Five ambulatory-care physicians were selected randomly from a staff of 15. Over age 65 male patients ( N = 329) were compared with 889 younger patients in regard to symptoms and medications. Patient-rated symptoms differed by age of patients but not by the five physicians. Comparison of 20 types of medications showed seven differed by patient age but none by physician. Analysis of data in an age × physician grouping, however, showed that certain physicians treated older patients differently in regard to use of digitalis, tranquilizers and pain medications. The findings suggest remarkable similarity in symptoms for older patients seen by different physicians. While use of the medications did not differ between physicians for patients as a total group, they did differ when age of the patient was taken into account. The inconsistent use of certain medications for the old without support of symptoms and diagnoses raises questions about how the old are viewed as a group by some physicians.