4 ms·

Actually don't know if that's true. As a former physician myself, in many circumstances, I would prefer a younger (to a degree) physician to a much older one.

by arn 13y ago

Actually don't know if that's true. As a former physician myself, in many circumstances, I would prefer a younger (to a degree) physician to a much older one. Medical knowledge does change relatively quickly and standards of care change a lot. For the same reason as engineers, it comes down to keeping up with the field. I don't know for a fact that an old physician hasn't kept up with the field, but I do know a younger one can only be so behind.

timr 13y ago
"Medical knowledge does change relatively quickly and standards of care change a lot." You have to be clear about the relative rate of change, though: it's nothing like software, where technical knowledge from a decade ago is completely irrelevant today. Medical appointments are pretty much the same as when I was a kid. The more important point, for me, is judgment: older doctors are far less goofy and spastic than younger ones. That means more conservative treatment, discretion, etc.
- ycombobreaker 13y ago
  > Medical appointments are pretty much the same as when I was a kid. I have a young child, and I have had enough conversations with doctors and nurses to see that standards for medical care _do_ change rapidly enough to matter. Some examples: - At the hospital where my wife gave birth, the SOP is an epidural and continuous fetal monitoring. This means that very little equipment is available which supports mobility. The hospital staff had a hard time wrapping their heads around the idea _lying on your back is painful_ for someone in labor. The human body hasn't changed, but the medical practices are currently optimized around the assumption of an epidural and keeping to a schedule. Doctors who have let this assumption ossify will force the hands of patients who simply don't know otherwise. - My pediatrician's practice currently recommends avoiding peanut butter until age... three? I think. However, there is recent research on some children of Jewish ancestry in the UK vs. Israel, suggesting that their very low rates of peanut butter allergy are probably due to environment rather than a genetic predisposition. If further studies confirm that finding, the AMA will probably revise its suggestions, causing all pediatricians to start offering the _opposite_ advice. - Recent research (sorry, don't have the reference) showed higher rates of food-related allergies when children were exposed to solid foods earlier than 3 months. [edit for list formatting]
  - timr 13y ago
    I never claimed that things don't change...just that the rate of change is pretty slow by comparison to software. Look at your examples: in the first, you're talking about the difference between laying down and...not laying down. And how long have people been giving birth in hospitals? In the second example, you're discussing a subtle difference in the age at which kids are fed a specific food. Medicine moves slowly and deliberately. Software does not.
    - ycombobreaker 13y ago
      > Look at your examples: in the first, you're talking about the difference between laying down and...not laying down. And how long have people been giving birth in hospitals? In the U.S., we've been giving birth in a hospital under the supervision of a doctor for several generations now. When my grandparents were of childbearing age, there were some pretty horrific practices. Now they are recognized as such, but the turning point occurred during someone's lifetime. Likewise, it doesn't sound like a big deal, but the culture of "laying down" has a significant impact on how we as a culture have babies: - The mother's position is not naturally conducive to popping a baby out. This adds difficulty to pushing. - The mother's position puts all of the baby's weight onto her back, rather than on her legs. This causes more pain, which can lead to further medicinal intervention (e.g. epidurals or IIRC narcotics). - Motion (walking, lunges, etc.) is helpful to get a fetus into the right position (head down, facing mother's back) and to advance its station. This benefit is lost while lying down. - Gravity is not of assistance while lying down. It helps while squatting. Etc. What sounds like such a little thing can end up making a world of difference. And today's ossified doctor who insists that the mother lay on her back is very similar to today's ossified developer who insists on using the Win32 C API for trivial data-entry UIs. Regardless of the rate of change of the field as a whole, ossification and inflexibility is problematic with whatever is changing right now.
      - timr 13y ago
        Your grandparents were of childbearing age a generation ago. When they were pushing out babies, computers didn't exist. Perspective, please.
- arn 13y ago
  > You have to be clear about the relative rate of change The exact rate of change is moot. The rate of change is "enough" over the course of 5-10 years, that it makes an impression on me.
biot 13y ago
As the human body hasn't changed much over time, I would expect an older doctor to be able to draw from experience and diagnose the underlying problem quicker. Ideally, for non-trivial issues, the older doctor would then refer the patient to a specialist in the field who keeps up-to-date.
- arn 13y ago
  > As the human body hasn't changed much over time But its our (your doctor's) knowledge of the human body that has changed immensely every decade.

by arn 13y ago

timr 13y ago

"Medical knowledge does change relatively quickly and standards of care change a lot." You have to be clear about the relative rate of change, though: it's nothing like software, where technical knowledge from a decade ago is completely irrelevant today. Medical appointments are pretty much the same as when I was a kid. The more important point, for me, is judgment: older doctors are far less goofy and spastic than younger ones. That means more conservative treatment, discretion, etc.

ycombobreaker 13y ago
> Medical appointments are pretty much the same as when I was a kid. I have a young child, and I have had enough conversations with doctors and nurses to see that standards for medical care _do_ change rapidly enough to matter. Some examples: - At the hospital where my wife gave birth, the SOP is an epidural and continuous fetal monitoring. This means that very little equipment is available which supports mobility. The hospital staff had a hard time wrapping their heads around the idea _lying on your back is painful_ for someone in labor. The human body hasn't changed, but the medical practices are currently optimized around the assumption of an epidural and keeping to a schedule. Doctors who have let this assumption ossify will force the hands of patients who simply don't know otherwise. - My pediatrician's practice currently recommends avoiding peanut butter until age... three? I think. However, there is recent research on some children of Jewish ancestry in the UK vs. Israel, suggesting that their very low rates of peanut butter allergy are probably due to environment rather than a genetic predisposition. If further studies confirm that finding, the AMA will probably revise its suggestions, causing all pediatricians to start offering the _opposite_ advice. - Recent research (sorry, don't have the reference) showed higher rates of food-related allergies when children were exposed to solid foods earlier than 3 months. [edit for list formatting]
- timr 13y ago
  I never claimed that things don't change...just that the rate of change is pretty slow by comparison to software. Look at your examples: in the first, you're talking about the difference between laying down and...not laying down. And how long have people been giving birth in hospitals? In the second example, you're discussing a subtle difference in the age at which kids are fed a specific food. Medicine moves slowly and deliberately. Software does not.
  - ycombobreaker 13y ago
    > Look at your examples: in the first, you're talking about the difference between laying down and...not laying down. And how long have people been giving birth in hospitals? In the U.S., we've been giving birth in a hospital under the supervision of a doctor for several generations now. When my grandparents were of childbearing age, there were some pretty horrific practices. Now they are recognized as such, but the turning point occurred during someone's lifetime. Likewise, it doesn't sound like a big deal, but the culture of "laying down" has a significant impact on how we as a culture have babies: - The mother's position is not naturally conducive to popping a baby out. This adds difficulty to pushing. - The mother's position puts all of the baby's weight onto her back, rather than on her legs. This causes more pain, which can lead to further medicinal intervention (e.g. epidurals or IIRC narcotics). - Motion (walking, lunges, etc.) is helpful to get a fetus into the right position (head down, facing mother's back) and to advance its station. This benefit is lost while lying down. - Gravity is not of assistance while lying down. It helps while squatting. Etc. What sounds like such a little thing can end up making a world of difference. And today's ossified doctor who insists that the mother lay on her back is very similar to today's ossified developer who insists on using the Win32 C API for trivial data-entry UIs. Regardless of the rate of change of the field as a whole, ossification and inflexibility is problematic with whatever is changing right now.
    - timr 13y ago
      Your grandparents were of childbearing age a generation ago. When they were pushing out babies, computers didn't exist. Perspective, please.
arn 13y ago
> You have to be clear about the relative rate of change The exact rate of change is moot. The rate of change is "enough" over the course of 5-10 years, that it makes an impression on me.

biot 13y ago

As the human body hasn't changed much over time, I would expect an older doctor to be able to draw from experience and diagnose the underlying problem quicker. Ideally, for non-trivial issues, the older doctor would then refer the patient to a specialist in the field who keeps up-to-date.

arn 13y ago
> As the human body hasn't changed much over time But its our (your doctor's) knowledge of the human body that has changed immensely every decade.