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For Doctors, Does Age Matter?

For Doctors, Does Age Matter?Inan op-ed published in The Boston Globe, Tufts neurology chairmanAllan Ropper defended the experience and cumulative skills providedby older physicians.Boston

Boston [03.15.05] Is older better? In the wake of a Harvard study suggestingthat younger doctors are more knowledgeable, diligent and carefulthan their more senior counterparts, a Tufts professor and hisHarvard colleague mounted a defense of older physicians like themselves.Citing the value of experience, the pair suggested that olderdoctors possess a wisdom that can only come with a long career.

"It isexperience that tips the equation toward quality. Informationalone, up to date or otherwise, is not the value added by thephysician," Tufts School of Medicine neurology professorand Caritas St. Elizabeth's Medical Center chief neurologist AllanRopper and Harvard Medical School neurology professor Martin A.Samuels wrote in a column published in The Boston Globe.

Accordingto the authors, the study omits several key factors that shouldbe considered when examining the relationship between the ageof the doctor and the quality of medical care.

"Noneof the studies addressed the age of the patients, a critical factorsince, on average, older doctors take care of older and sickerpatients,” Ropper and his colleague wrote in the Globe.“Nor was the complexity or severity of illness taken intoaccount. As disturbing was the focus on written standards fordiagnosis."

The doctorsnote that they recognize the value in establishing medical standards.

"Largestudies that lead to the generation of guidelines are valuablefor extracting trends that cannot be appreciated by a single doctor,"they write. "They are a great aid to the new physician inknowing where to start. They are an antidote to the individualphysician making the same mistake over and over and calling itexperience."

Standardsalone, however, are not what patients need, according to the authors.

"Anyonecan apply guidelines written by committees, but patients do notcome to see doctors for a more fastidious application of standards.They seek wise and compassionate analysis of their particularproblem," they wrote.

The valueof years' worth of diagnoses and patient encounters is key, theyobserve.

"Thepractitioner who fails to pay attention to the results of previousencounters is missing a singular opportunity to improve his orher judgment," the doctors wrote.

Too much relianceon predetermined guidelines and procedures, they contend, is reducingthe efficacy of medical practice.

"Doctors,if anything, are not lacking information but they are beginningto sadly lack the confidence to believe their own eyes and ears,"the neurologists wrote."This loss of dimensionality has homogenizedmedicine and will produce the absolutely average care to whichsome studies seem to aspire."

Older doctors,as the saying goes, have time on their side.

"Theexperienced physician, having been on the scene for a few years,has watched styles and fads come and go. This tempers the overlyquick adoption of new treatments and protocols," Ropper andSamuels wrote in the Globe.

The patientsthemselves, the authors conclude, confirm the need for a physician'sexperience as a complement to the latest data.

"Manypatients do indeed seem to want a doctor with judgment and experience,"they wrote. "They apparently have a sense that these qualitiescount. Why? For one thing, they recognize that the trick is notsimply to have information, but to apply it properly to them,to their illness over time."










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