The New York Times recently had an interesting article “Does Your Doctor’s Age Matter?” It was authored by Dr. Haider Javed Warraich, a 29 year old Fellow in Cardiovascular medicine at Duke University Medical Center. In the article, Dr. Warraich states that, when it comes to choosing a doctor, patients place a premium on age because they equate age with experience. Dr. Warraich argues that “In medicine, a lack of experience may actually not be a bad thing” and to support his opinion he cites a Harvard research study which says that patients treated by younger doctors are less likely to die. The study concluded that younger doctors are less likely to 1) order unnecessary tests 2) to face disciplinary action and 3) be cited for improper prescription of opoid painkillers and controlled substances. It also found a positive correlation between lack of experience and better quality of medical care. Younger doctors were found to be more likely to use innovative practices, learn new procedures and be free of relics of the past.
Now, I have the highest respect for Harvard University but I find it difficult to accept these findings. For one thing, I have no idea how pronounced the results were in favor of younger doctors. How strong was the correlation between lack of experience and better medical care? Furthermore, some of the conclusions seem contrary to what common sense tells me. It seems to me that younger doctors, because of their inexperience, would be less confident and thus likely to order more tests rather than less.
I prefer to trust my own experience with doctors even though it is anecdotal.
To begin with, let’s agree that age and competence are not mutually exclusive. There are some good young doctors, some bad ones and many in-between. There are also some good old doctors, some bad ones and many in-between. I would not choose a doctor solely based on age. If a good friend strongly recommended a doctor (and if that doctor accepted my medical insurance), I would want to be his patient regardless of his age. I will admit that if a doctor was very youthful, I would be a little uneasy about his skills and I would definitely be uncomfortable dealing with him because of the generation gap. Contrary to the Harvard study, which said that younger doctors are “more likely to place the patient on a pedestal than themselves”, I have found younger MDs to be brash and less respectful. Sometimes, I also feel they are less interested in older patients, an unspoken vibe that “You have had your innings already.”
The one thing that I will agree with is that younger doctors are likely to be more innovative and open to new procedures and techniques. I remember that when my wife was considering a knee replacement we were very impressed by a local surgeon who had performed thousands of such operations and received the highest accolades from his patients. Then, a close friend told us of her experience with a surgeon in his forties who used new techniques that resulted in less invasive procedures, smaller incisions and a much reduced rehabilitation period. My wife doesn’t need the surgery anymore but, if she did, I know which one she would prefer.
On the other hand, medicine is not only a science but an art. Med school is only the beginning of a doctor’s education. The greater part of his education occurs later as he hones his skills on real world patients, real life situations. I remember a doctor who used to practice in Rahway. He was not impressive in his appearance or manner but his diagnostic skills were phenomenal. He was able to accurately diagnose what was wrong merely by listening to a patient’s description of symptoms and by asking the right questions. His patients loved him and valued him highly. His office receptionist once said to me, “If I ever fell ill, there is no one I’d rather have as a doctor than Dr. M.”
Insofar as choosing a doctor for myself is concerned, I would opt for the one who was strongly recommended, regardless of his or her age. Wherever possible though, I’d choose one who was in his or her fifties or younger but that is for a practical reason. I want a doctor who is not close to retirement age, one whom I can rely on for the next several years.
Golden Ripples 