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Thursday, October 23, 2014
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Published: Sunday, 3/27/2005

Shop with care before choosing a doctor

Picking a doctor to provide routine medical care, or a specialist to treat some complicated disease, takes some checking beyond looking for someone with an office located conveniently near your home or work.

For instance, it's important to check on whether the doctor is "board certified," which means the person met strict standards and passed a test given by organizations like the American Board of Family Medicine, the American Board of Internal Medicine (ABIM), or the American Board of Dermatology.

Many patients ask friends for a recommendation, or limit their searches to doctors at a university medical center or a local hospital with an especially good reputation.

Age often enters into the decision, as well. Almost everyone has had the thoughts: "She's just a kid. She needs to get some practice, and not on me!" "With 40 years of experience, he must be good."

Conventional wisdom says that older doctors are best. They draw on decades of experience with all kinds of patients and diseases. Doesn't practice make perfect? Don't doctors who've been practicing for a long time have more knowledge?

Those idea seem headed for medicine' scrapheap, at least until medical organizations can revamp their continuing education programs to fill a newly identified knowledge gap among older doctors.

Researchers from Harvard Medical School identified the gap in an analysis of 59 studies done between 1996 and 2004. The studies included data on the link between experience and age and several indicators use to measure how good a physician performs. The data allowed researchers to answer several questions:

Do older or younger doctors have more medical knowledge? Which ones tend to treat patients according to nationally accepted standards and guidelines? Do patients fare better when treated by a younger doctor or an older one?

Much to their surprise, 70 per cent of the studies showed that practice does not make perfect. On each of those 3 key questions, younger doctors did better than their older counterparts.

Two leading organizations devoted to improving patient care noted that the study did not include important traits like judgment and humanism, which may improve with age.

But the groups - the American College of Physicians (ACP) and the ABIM - termed the findings "striking" and "a wake-up call to the medical profession."

Even if judgment and the human touch do improve with age, they said, the wisest and most caring doctors still must sat up-to-date with the latest scientific knowledge about the best ways to diagnose and treat their patients.

Dr. Niteesh K. Choudhry, who headed the study, cautioned against concluding that all older doctors have fallen behind. Many may, indeed, keep pace with new medical developments and pack an unbeatable combination of experience, wisdom, and knowledge.

However, the ACP and ABIM think many have not, and are moving ahead with new continuing education programs to assure that all older doctors stay tuned in to the blistering-fast advances in medical knowledge.



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