Saturday, January 6, 2018

Are Young Doctors Better?

In this Sunday's New York Times op-ed, Dr. Haider Warraich, a cardiovascular medicine fellow at Duke University, makes a fairly convincing argument that young physicians are better doctors than their older colleagues.

He cites research that shows patients treated by younger doctors have a lower mortality. They are less likely to overprescribe medications and order unnecessary tests. Young physicians are also not as likely to be brought before their state medical boards for disciplinary action.

Why is that? Older doctors are more set in their ways. They may not be as familiar with the newest medications or the latest protocols to treat a medical condition. Their skills may not be up to date with the latest techniques. And let's face it, we've all seen the curmudgeonly doctor who refuses to change his ways no matter how archaic their thinking may be.

The older doctors benefit from their ability to maintain their board certification for a lifetime. While new doctors have to pay exorbitant fees and spend countless hours to keep their ability to practice medicine, older physicians can continue to use information they learned in training decades earlier to muddle through their careers and nobody will call them out on it.

Due to this leniency a large number are continuing to work past the usual retirement age. About twenty percent of doctors are currently over 65 years old. That is expected to rise to a third in only three years. Personally in our anesthesia group, we have many partners who have elected to work part time instead of retiring, thus limiting the ability of the group to hire new younger doctors to freshen the blood in the organization.

Yet it is the young doctors who will be looked upon with suspicion from their patients. When patients and their families remark on how youthful their doctor looks, that is not a compliment. They are questioning in an oblique way the qualifications and experience of the physician that is sitting in front of them. Unfortunately there isn't a simple way to allay their fears short of bleaching one's hair white. The smart patients will welcome the enthusiasm and knowledge that a younger doctor brings to the table because sometimes experience isn't the best teacher. It's the training, not the wrinkles.

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