A s we grow older, we're more likely to have health problems that require first-rate medical care.

Unfortunately, as many seniors have learned, it can be hard to find a doctor suited to care for their special needs.

How can older people be sure to get good medical care? Dr. Robert Butler, a well-known crusader for elder rights, explains how important it is to watch out for mistakes doctors sometimes make when treating elderly patients...

MISTAKE: Failing to appreciate the physical changes that come with age. A disease that causes one set of symptoms in a young person may manifest itself quite differently in an older person. Not all doctors realize that. And an unwary doctor can easily miss the diagnosis.

Example I: If a 30-year-old man suffers a heart attack, he is likely to experience severe chest pain. But chest pain affects fewer than 20% of older heart attack victims. Instead, older victims may simply seem weak or confused.

Example II: An older person suffering from an overactive thyroid may exhibit apathy instead of hyperactivity, the classic symptom.

MISTAKE: Urging older people to "take it easy." Even if you've been disabled by a stroke or another medical problem, leading an active lifestyle helps keep you healthy -- and happy.

Even people in their 80s and 90s can develop big, powerful muscles with a program of weight lifting. Such a program can literally put a bedridden patient back on his/her feet.

MISTAKE: Being too quick to blame health problems on old age. Doctors often assume that health problems are inevitable in older people, exhibiting a defeatist "what-can-you-expect-at-your-age?" attitude.

They order fewer diagnostic tests and generally treat disease less aggressively in old people than in young people.

Example: An elderly woman seems confused and disoriented. Assuming that she has Alzheimer's disease, her doctor neglects to order tests that might show the real culprit to be an easily correctable drug reaction.

MISTAKE: Not giving the patient enough time. A good physician takes the time to ask about your work status and lifestyle as well as your medical problems... and, in general, makes you feel taken care of.

At each office visit, the doctor should ask about symptoms you have reported in the past. He should also review your response to medications... and ask about new problems.

Your first visit to a new doctor should be devoted to giving a thorough medical history and undergoing a physical exam and lab tests. This can take more than an hour. Once this comprehensive exam is completed, you probably won't need another exam for a year -- unless there's a health crisis.

MISTAKE: Failing to advocate preventive measures. Some doctors seem to think, "Why bother trying to lower an elderly patient's cholesterol level. He's just going to decline anyway."

We now know that heart patients of any age can benefit from a program of dietary modification, lifestyle change and -- if necessary -- medication or surgery.

MISTAKE: Giving inappropriate prescriptions. Doctors are too quick to order tranquilizers and antidepressants for their older patients, thinking -- incorrectly -- that psychotherapy is of no use. And they often fail to realize that older bodies respond differently to drugs.

Example: It can take an older person twice as long to "clear" diazepam (Valium) from his body as a young person. A dose that would be appropriate for a young person could make an older person drowsy.

If you're not sure that your doctor knows about all the drugs you're taking, put all of your medications (including nonprescription drugs and herbal remedies) in a paper bag and bring them with you to your next office visit.

For referral to a certified geriatrician in your area, call the American Geriatrics Society at 800-247-4779.