Is Your Doctor Too Old for You?
By: Amy Dunn Williams
| One afternoon a few years ago, as Kat Carney sat watching TV, she became overwhelmed by chills and a sudden fever that quickly reached 102 degrees. She had her period at the time and worried that her symptoms could be a sign of toxic shock syndrome, a rare but potentially deadly ailment often associated with tampon use. Carney called a friend to take her to the hospital; by the time they reached the emergency room, her temperature had climbed to 104 degrees. |
| "I asked my doctor right away if he thought I could have TSS," says Carney. "He dismissed me." |
| The doctor, who had been in practice for many years, kept Carney in the ER for hours, running a battery of tests and eventually diagnosing her with a respiratory illness. "I didn't think his diagnosis made sense," she says. "I asked him again if he thought it could be TSS, and he said 'Lady, women come in here all the time thinking they have TSS, and in all my years of practice, I haven't seen one case.'" The doctor sent her home. |
| Over the next few weeks, Carney's conditioned deteriorated. She was weak, experiencing pain throughout her body, and the skin was peeling off the palms of her hands. Unsure of what to do next, she made an appointment with a dermatologist. |
| "He was a young doctor," Carney recalls. "He took one look at my hands and said, 'Have you had toxic shock syndrome recently?'" |
| Carney has since been successfully treated for her TSS, but says she learned an important lesson from her experience. "I know now to look for doctors who stay up on current research and who aren't so stuck in their ways that they won't consider a variety of reasons for their patients' symptoms," she says. "After I was diagnosed with TSS I called the Centers for Disease Control (CDC) to ask if there was a test the ER doctor could have done for toxic shock, and discovered that there is. He just wasn't willing to perform that test." |
| Carney is not alone. A 2005 study conducted by the Harvard Medical School and published in Annals of Internal Medicine found that the older a doctor is, the less likely he or she may be to provide patients with the most up-to-date care. Relying on skill sets honed long ago, these doctors are far slower to adopt new standards of care; for example, less invasive surgery options for early-stage breast cancer patients.
The study also showed that doctors who graduated 20 years ago or longer are more than 40 percent less likely than their younger counterparts to offer preventative cancer screenings widely endorsed by the American Cancer Society as well as the National Cancer Institute. Older doctors also may not correctly diagnose or treat depression and anxiety, or adequately counsel their patients in emergency contraception. |
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Despite these findings, it's unwise to simply dismiss or blindly trust a physician based on his or her age. So what can we, as patients, do to ensure we are receiving the best possible care?
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| Educate Yourself Dr. Robert Fletcher, MD, co-author of the Harvard study, recommends that patients educate themselves about symptoms or general health concerns before seeing their doctors. "Preventative care guidelines are widely available to patients on the Web," he says. "Before seeing your doctor, do some research to find out what preventative care services are recommended for people your age and gender, with your family history and lifestyle." Dr. Fletcher says that a little bit of research can open the door to asking the right questions, allowing you to take full advantage of your time with your doctor. And if he or she isn't willing to address your concerns or quickly dismisses your questions? It may be time for you to start looking for a new doctor.
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Ask the Right Questions |
| Your doctor should be able to discuss why he or she favors a particular option and should be able to cite current, relevant research to back up that point of view. |
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Dr. Scott Whitten, MD, a reproductive endocrinologist in Reno, Nevada, recommends asking your doctor if there are any new treatment options or diagnostic tests available. "Keep in mind, however, that new doesn't always mean better," he cautions. "Often times, both patients and physicians get excited when new treatments are revealed. Make sure to talk to your doctor about the clinical research that has been conducted on the new treatment and what the risks associated with it may be."
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| Spot the Warning Signs Even when you're asking all the right questions, how can you really be sure that your doctor is changing with the times? "The real warning sign that a doctor isn't aware of the newest research findings is the absence of journals, current books, modern computer programs, and other sources of up-to-date information in a doctor's office," says Dr. Fletcher. Unfortunately, most patients only ever see the inside of the exam room, not the inside of their doctor's office, making it difficult to know if these things are present. Dr. Fletcher adds, "Patients might ask, 'How do you keep up with all the new information that's out there, Doctor?' Ask them what medical journals they read, or if they subscribe to UpToDate, an electronic textbook of medicine that is continually updated." You might also ask your doctor to recommend, or provide you with, some literature on your condition and the treatment options available. |
| Another warning sign is a seeming refusal to admit his or her own limitations. "No doctor can be expected to have committed to memory all relevant information," says Dr. Fletcher. "A good doctor realizes this, and will have a feasible way to look up the information they need." In other words, sometimes what you really need in a doctor is someone who isn't afraid to say, "I don't know." |
| Finally, look for a physician who is forthcoming with information. "The most important feature of the doctor-patient relationship is trust," says Dr. Whitten. He explains that patients can trust a doctor who can adequately explain his or her reasons for choosing a particular therapy, the alternatives to that therapy, and how it may or may not help. "If your physician is unwilling to provide you with this information," he says, "it may be time to consider a second opinion." |
