A GOOD AGE; When It Comes to Doctors, Does Age Matter?

Sue Scheible

When Lee Salvucci switched to a new doctor 24 years younger than she is, it took a while “to really think of her as a doctor,” Salvucci said.

“She seemed younger than my children when I first went to see her.” It didn’t take long, however, for the active senior to realize how much her new “younger” doctor knew. Salvucci, now 73, and her internist, Dr. Martha Moss at Harvard Vanguard Medical Associates in Quincy, are still together after more than eight years.

“I feel she takes a personal interest, and sometimes with medical appointments, you can feel you are just a number,” Salvucci said. “She’s warm. She really listens, and I don’t feel she just goes by the book. She has suggested tests and followed through on things.”

Those qualities are the same reasons many people are loyal to their “older” physicians, whom they’ve often been seeing for years.

Does age really matter in medicine? A recent news report raised the issue, as well as some hackles, when it found that older doctors may not be as good as younger doctors.

The Harvard Medical School study suggested that older doctors tend to provide lower-quality care than younger doctors who recently graduated from medical school. The research results were published in the Feb. 15 Annals of Internal Medicine.

“Physicians with more experience are generally believed to have accumulated knowledge and skills during years in practice and therefore to deliver high-quality care,” the article by Dr. Niteesh Choudhry and others stated.

Instead, the study concluded that doctors who’ve been practicing longer may provide lower quality care and may need to be monitored in their practices. “While ‘practice makes perfect’ in some situations, physicians’ knowledge and performance may decline with the passage of time,” it stated. The study found:

Older physicians were less effective in a wide range of areas, from following appropriate cancer-screening techniques to diagnosing depression to prescribing aspirin to angina patients. Heart attack patients were 10 percent more likely to die if their doctors were 20 years out of medical school, compared with doctors who were recent graduates. Medical advances occur frequently, and the knowledge physicians possess can easily become outdated. Many patients think doctors who have been practicing longer have superior clinical skills. But these older doctors may not be as skilled at the latest technical procedures. The analysis did concede that older doctors may improve over time in ways that are hard to measure, such as gaining a patient’s trust. For example, two studies found older doctors became more adept at advising patients to exercise and at referring diabetic patients for eye tests.

Salvucci has had very positive experiences with both “older” and “younger” physicians. Her previous internist was closer to her own age. She only switched doctors because her health plan changed its list of doctors. “You like to think of the older ones as wiser, and I guess from what the medical study found, sometimes they don’t keep up with things,” she said. She found news of the study to be “disappointing” and said that older people she knew were talking about it. “But I think it’s positive in one way – many people have younger doctors and may feel more comfortable with them because of the study.” When Salvucci had to select a new doctor, she wasn’t really looking at their ages. “I always like to know what their medical background is,” she said. She also decided she wanted another woman doctor. “And I like an internist, because they are well rounded and refer you to a specialist if you have special problems,” she said. For example, someone with heart problems might choose a cardiologist as their primary care doctor, she said.

After she decided she liked Moss’ medical background, she scheduled a visit with her. “The initial contact with a new doctor is important,” Salvucci added. “Whether you have rapport with the doctor and trust your instincts counts for a lot.”

If you need a specialist to perform a new surgical or technical procedure, you should check to see what their training and experience in it has been. Younger doctors may have learned it in medical training and actually done more of the procedures.

But age should not be the only factor in choosing a doctor. Many older people feel unswerving loyalty to doctors they have come to trust and whom they can talk to – without being condescended to or lectured. Physicians who can take time to listen to a list of questions are golden. Some patients will even say it doesn’t matter to them if their doctor isn’t up on all the latest advances – that medical recommendations keep changing anyway, and that communication matters more.

So much of age and aging is relative. However, a doctor should be board certified in their field of practice. That is the “seal of approval” given by boards of experts representing the medical specialties.

An editorial with the study recommended that doctors also be required to undergo re-certification training to stay current with new advances.

MEN OF HARMONY – The South Shore Men of Harmony barbershop chorus, featured here Feb. 7, had some funny experiences on Valentines Day when they delivered “singing valentines” throughout the area. Working in quartets, they were sent to one preschool to serenade one of the staff in “I Love You Truly” and as soon as they broke into song, the 15 little kids broke into tears. Another assignment found them singing “Heart of My Heart” to a mostly naked gentleman (he had a towel draped around him) being massaged by a masseur. His wife sitting outside had ordered the valentine.

Reporter Sue Scheible can be reached at 617-786-7044, by mail at The Patriot Ledger, Box 699159, Quincy, MA 02269-9159 or E-mail at sscheible@ledger.com.