Marcus Welby vs. Doogie Howser

Is your doctor's age only a number?

21 Oct 2019 | 10:42

As you slide towards your Golden Years, three things are certain: Death, taxes, and the fact that when your own familiar doctor retires, his replacement will likely be 30 or 40 years younger than you.

The median age for American primary care physician retirement is 65, and the number of doctors reaching that mark is rising. In 2010, the Federation of State Medical Boards’ counted about 16 percent of our doctors in their 60s and 9 percent in their 70s. By 2016, it was 19 and 10 percent, suggesting that a lot of patients will be soon looking for new and likely younger MDs.

How will that affect patient care? Depends on whose study you read.

First up, Vanderbilt School of Medicine pediatrician and health policy expert William Cooper. His 2017 survey of more than 1,300 ophthalmologists at 20 different hospitals and groups found that as the age of the doctors crept upwards the number of complaints went down. Maybe, says Johns Hopkins ophthalmologist Michael Repka, age brings experience and a better ability to deal with patient problems.

On the other hand, younger doctors may be more up-to-date with current medical practice, and they do seem to keep their-hospital patients alive longer. Two years ago, Harvard researchers collected data on nearly 750,000 seniors treated by nearly 19,000 different doctors at a whole slew of different hospitals. Their conclusion, published in the British Medical Journal, showed that for every 77 patients treated over a period of three months, doctors age 60+ lost one more than did 40-year-old MDs. To be fair, there were caveats. Elderly patients treated by female doctors fared better than those treated by males, and older doctors who saw lots of patients – more than 200 a year – delivered the same quality of care as their younger colleagues.

"Red Flags" to Watch For

How to judge who’s on game and who isn’t? Certifying specialty groups such as the American Board of Internal Medicine (ABIM) require their guys to pass Maintenance of Certification exams every 10 years to keep their board-certified status, and some hospitals have come up with testing programs for older physicians.

But studies of thousands of doctors don’t necessarily say anything about individual doctors, like yours. How to tell if you need to look for a new one?

Jonathan Maltz is a family physician with a 40-year practice in Olney, Maryland. Last march he published an op-ed in The Washington Post with a few “red flags” to watch for: Does a doctor you’ve known for many years suddenly confuse you with another patient? Does she forget to do basic stuff such as suggesting a pertinent test? When you ask a question, do you get a sensible answer? More alarming, does his hand shake when he picks up an instrument?

Of course, even younger doctors can make mistakes and drop an instrument now and then, so Arthur Caplan, Director of Medical Ethics at NYU Langone Health, says age alone is not a reliable indicator as to who’s right. His advice? Look for a doctor who comes highly recommended, has trained at strong schools, is board certified and associated with a hospital or academic medical center where expertise is readily available should you need it.

And finally there’s this to complicate the picture: In Manhattan, many older established physicians now run “boutique” practices which do not accept any insurance, including Medicare. Age may be only a number, but so is your medical bill, which is why an increasing number of New Yorkers opt for the new urgent care centers staffed primarily with younger doctors that are pleased to honor your insurance.

But that’s a story for another day.

Does a doctor you’ve known for many years suddenly confuse you with another patient? Does she forget to do basic stuff such as suggesting a pertinent test?