Underdosing exercise for older adult clients may jeopardize quality of life, functional capacity and independence, leaving vulnerable older adults at risk for falls and other secondary conditions related to weakness and deconditioning. In a healthcare environment with care limits and disparities, excessively conservative interventions waste valuable resources and result in sub optimal outcomes. There is no excuse for complacency or ageism bias to compromise the quality and effectiveness of physical therapy interventions. This discussion is applicable across all practice settings for all therapists who treat middle age to older adults.