Older Docs, Wiser Docs

When thinking about physician recruitment, most physicians picture a fresh-faced young man or woman joining their practice. Indeed, the vast majority of new medical school graduates pounding the pavement are 24 to 29 years old, according to the Association of American Medical Colleges.

But a small portion of the graduating class -- usually around 8 percent -- consists of older potential recruits, over age 33. Yes, it's true that this age group will have more family responsibilities and an abbreviated work life, but this breed of physicians can offer certain advantages to practices.

For example, "the older doc is more settled, so the retention is better," says Nelson Tilden, a medical consultant, trainer, and founder of New York-based Medical Search Institute. "So many young physicians have a lot of debt and will go to a practice that will pay, but they won't necessarily stay there."

A 2000 Merritt, Hawkins & Associates study reported that 37 percent of physicians over age 50 planned to retire within one to three years. Since one-third of the nation's 740,000 physicians are 50 or older, it may be wise to consider hiring non-traditional recruits.

Benefits to you

An older person also has life experiences in managing money, resolving conflicts, building relationships, balancing a family life with demanding careers and schedules, and possesses other useful acquired skills.

"When I was young, I had this naive courage which got me through a lot of things. That jump-first-and-look-later attitude can be very helpful in medical school. Now that I'm older, I just don't have that," says 41-year-old Mike Grasso, who started medical school last fall. "But that's OK, because I know I bring other things to the table. I'm more mature; I'm more confident in my abilities. I understand my limitations, and I'm better at managing my time," says Grasso, who lives with his wife and four children in Laurel, Md.

Deborah Bowers, a 38-year-old new physician, agrees. "You come to the practice with other life skills. You come with a broader sense of yourself," says the former nurse who joined a practice in northern Virginia last year.

Equally important, this crew is willing to work within the current constraints of medicine. While today's older physicians who graduated from medical school in their 20s come to the table with different expectations --  rebelling against managed care and facing shrinking salaries and spiraling malpractice rates --  more mature graduates recognize these problems with less frustration.

"I believe that I and most of my classmates will simply work with this system because this is the one we're learning in," says Mary Renard, a 46-year-old medical student and mother of three.

"For physicians who've been practicing for more than 10 or 15 years, I think the feeling is that they've 'changed all the rules' when it comes to things like managed care, paperwork, malpractice rates. I think those of us entering into practice now would be well-advised to note that things keep changing," says Renard, who will graduate from George Washington University School of Medicine in 2004.

Plus, this older group has a work ethic more compatible with that of others their age. Whereas a 30-year-old might expect to work short weeks and still make a dot-com salary, a 40-year-old already knows nothing in life is free.

Real dedication

In fact, far from expecting too much, people who choose to become physicians later in life are often leaving even more lucrative careers, sacrificing salary for personal satisfaction.

Thirty-five-year-old Eric Loeliger is one of these people. While living in Tokyo in 1997, Loeliger learned he was not accepted into medical school. So, he quit his $85,000-a-year sales job, and he and his wife returned to the States "to fill in the holes" on his application. He lacked healthcare experience; he had to prove he really wanted to become a physician. His solution? He started volunteering at a hospital and also grabbed a part-time gig in the lab at $12 an hour.

His life as it was in Tokyo -- including plenty of travel and at least twice-weekly $200 dinners with his wife --  has all but ceased. "Now, we haven't spent $200 total in the last few weeks," Loeliger laughs. He sold their nice house and now rents. He replaced his comfortable company car with a 1993 Escort.

But would he go back to the riches and perks? Not a chance.

"As soon as I made the mental switch to another career it was like I was on cruise control. I couldn't stop doing it. There was nothing else I wanted to do," he says.

As Loeliger prepares to graduate this spring and start an emergency medicine residency, he reflects on what he "gave up" and says it's simply a matter of changing priorities. Comments about his age from students, usually 10 years younger than Loeliger, used to frustrate him until he began to take a different view. "They used to ask, 'why would you give up your life now and do this?' But then I thought, 'I've lived a great life; I traveled and did a lot of things I wanted to do, but they haven't be able to do that yet.'"

Renard, too, knows all about melding med school with real life after her 20-year break from school. "I did general chemistry problems while driving to my eldest son's college. I brought organic chemistry notes to study while I waited for my son's football team to take the field. I hauled an MCAT review book with me on a trip with my daughter's skating team," she says.

Who do patients want?

Bringing on new, yet more mature, physicians also has benefits for patient relations. Ask yourself: Who do our middle-aged and elderly patients want caring for them?

"I can identify with those patients --  I have some of the same maladies, like asthma and arthritis, so I can relate," says 54-year-old Bruce Stafford, DO, now in his second year of residency at Oklahoma University Medical Center, department of family medicine. "I'm not a 28-year-old doctor who can't relate to joint pain."

Tilden agrees. "Patients respect age and experience a lot in medicine."

Apparently that belief holds true for Renard, as well. "I think I'll be well-accepted by patients. I have already found, in seeing patients as a medical student, that they feel very comfortable with me," she says. "Part of that is that I am comfortable with them, and part is that patients --  especially those who are themselves middle-aged or older --  seem to be able to relate well to me."

And it's important to remember that the physician you hire must sometimes discuss difficult issues with patients, which can be a whole new experience for 20- and early 30-somethings.

"Because I used to be an ICU nurse, I had dealt with death and dying issues before," says Bowers. "Some of the residents in my class couldn't talk to patients and their families about death because they themselves couldn't deal with the fact that someone was going to die. There's no class in medical school called 'Let's Talk,'" she says.

Renard agrees and says she's up for the challenge of discussing sensitive topics. She looks forward to being an "advisor" in her physician role. "I relish the idea. I know I will be good at talking to people about tough stuff. My life experiences will help."

Mentoring older docs

If you've hired or are thinking about hiring a more mature, new physician, don't forget that they need the same support system as other new physicians.

"I'll be over 50 when I am looking for a job in private practice," says Renard, "but don't assume I know more. I will be just as thirsty for knowledge as a 26-year-old."

Bowers points out that she found it important to work in a place where she respected other physicians' clinical skills and the way they practiced. "I picked a practice where I knew they would make an investment in fostering me. It's important that the more experienced physicians are available to the newer ones."

In turn, some of these physicians propose they'll come full circle by becoming role models for the next batch of new physicians.

"I'd like to be a mentor to younger people. I've been through trials and tribulations similar to theirs so I can relate," says Stafford, who was an engineer for 25 years.

Grasso, a former computer scientist, has gone so far as to develop his own Web site (www.cs.umbc.edu/~mikeg/medschool.html) dedicated to non-traditional medical students who want more information on medical schools, stories from students, the MCAT, and more. The site has received 64,000 hits since 1998. "It's the mentor in me to help others who are going through the same difficult decisions I did," he says.

So, when looking for a new physician, don't limit yourself to the youngest and the brightest --  also consider the older and wiser. Brand-new docs pushing 40 or 50 may be exactly what your practice needs.

Karen Gatzke can be reached at editor@physicianspractice.com.

This article originally appeared in the May/June 2002 issue of Physicians Practice.