Is your doctor’s age a factor?

Is your doctor’s age a factor?

It’s hard to choose a doctor, and you’d be right to consider everything from education to experience and specialty to board certification. But the personal things matter, too–temperament, bedside manner, gender. Is your doctor’s age a factor?

I’ve reached the age, it seems, when many of my doctors are younger than I thought it was possible to be. I’m almost old enough to be the parent of the prodigies, 30 something Doogie Howsers.

When I was in the hospital, terrified and waiting for, what turned out to be, a diagnosis of cancer, the doctor who saw me seemed a lot taller and a lot younger than I expected him to be. Lying in a hospital bed, shrunken in your mind’s eye, everyone seems to loom over you, but my doctor is not actually all that tall. He is, however, actually as young as he seemed, 32 or so according to online sources. Too young?

What do you want in a doctor? Experience. Skill. Maturity. Wisdom. All of these seem to derive from age. The right age for a doctor seems to be, in my gut reaction, someone my age. How could anyone who hasn’t lived as long as I have know enough to save my life?

When my young urologist first saw me in his office after the diagnosis, he handed me the NCCN, National Comprehensive Cancer Network, guidelines for treating bladder cancer. This organization brings doctors and other clinicians, scientists and researchers, together to establish protocols for treating cancer across the spectrum. The document for bladder cancer is 59-pages long, a series of matrices (that spell out in 8-point type treatment plans from the earliest stage to the most serious). It is evidence-based medicine at its best.

I’m sure that other urologists do the same thing, but I know that many of them do not. According to this CBS news report  from 2011, 42% of doctors fail to follow the correct follow-up guidelines.

If you’re after evidence-based medicine, you might want a younger doctor trained more recently by medical schools that value such protocols. I assumed that more experienced doctors would be more likely to follow the appropriate guidelines, but Consumer Reports suggests experienced docs provide worse care. “In general, if your priority is someone familiar with current evidenced-based standards of care, you may want to opt for a younger physician.”

In the same article, Consumer Reports reports that older doctors may have better bedside manner, but that has decidedly not been my experience. My two favorite doctors, primary care and specialist, are very (painfully?) young. Both bring the knowledge and evidence-based care that is so important to me. In addition, they bring openness to my questions and my own research.

When I bring one of the hundred articles that I’ve found on this strain of medicine or that surgical procedure, both have reacted with the enthusiasm of confident, engaged teachers. They’re pleased that I’m involved and that I ask questions. They’ve treated me as a member of my health care team. Seems fair since I’m the most important member of the team.

That hasn’t been the case with some of the older docs. In some notable instances, the doctors seemed troubled by having to interact with me at all. One clearly didn’t want me to ask any questions and the other wanted to make critical decisions for me. Another felt threatened by my questions and warned me not to “micromanage” the situation.

My diagnosis of these docs was “paternalism, aggravated by sexism.”

Perhaps this conclusion springs exclusively from my biases. In any case, my biases help create the context for the relationships that I have with my doctors. As a college professor, I’m used to both interacting with younger people and to taking their work seriously. I bring a sense of confidence to conversations with younger people. I’m used to being taken seriously by students and to taking the lead with them.

I am also used to inquiry as a model of interacting with the world. Asking questions, doing research, and compiling resources are part of my job. I wonder if the younger docs, being closer to the student experience, are more comfortable in that context as well.

Since my diagnosis in August, I’ve seen about 10 different doctors for various aspects of my health. While I know that my personal experiences do not constitute proof, I have to say that “young” is now one criteria I like in a doctor. It isn’t the only one, of course, but I now seen youth as a value.


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