The Older You Are, the Less You Know?

Yesterday, Amanda Gardner of HealthDay reported on a recent study regarding the performance of older physicians. Apparently, the study's authors found that the longer a doctor had been out of formal training, the more out-of-step he/she was in terms of current best practices. While those of us who work in health care have long held sneaking suspicions about older doctors, the general public may find these results surprising.

Studies like this hopefully will help to clarify the difference between "knowledge" and "wisdom." The former implies facts, figures, and perhaps abstract ideas and concepts. The latter is a little more ambiguous, implying experience, a greater sensitivity in how to handle delicate matters, and maybe (only maybe) a higher degree of virtue.

While older doctors are perhaps "wiser," due, if nothing else, to their age, both young and old can be knowledgeable. With the exception of very young children, knowledge is basically age-neutral. If a four-year-old tells me that the capital of Mongolia is Ulaanbaatar, and a 40-year-old tells me that it's Detroit, the former is correct (assuming we can believe sources like Wikipedia).

Hopefully, one of the effects of the ever-increasing use of technology in medicine will be the acknowledgement that physicians cannot hold the vast store of medical knowledge in their heads, and that they must refer to external sources. My primary care physician (still a relatively young practitioner) utilizes his computer in the examining room to access medical databases and the Internet. He freely admits his lack of omniscience and told me how, when he was a resident, he had shocked the nurses at his clinic by admitting that he didn't remember the exact schedule for childhood immunizations. He felt that if he had tried to remember it, he eventually would have made a mistake — better just to look up the information when necessary.

Such honesty and humility from a professional—whether young or old—is not only refreshing...it's probably safer.