Heuristics are “rules of thumb” that people use to make decisions in situations that involve uncertainty. Taleb writes about them in depth and I enjoy his writing. The daily practice of medicine requires making frequent high stakes decision with incomplete knowledge. Where “evidence based medicine” leaves off, heuristics often take over.
I think both doctors and patients use them, but in different ways.
I was thinking about shortcuts that patients use to help them decide on whether their doctor is competent or not. This is different from how they choose their doctors. That’s another topic. I mean after the patient has initiated a relationship with their doctor they will consciously or subconsciously assess the physician’s competence based on a host of factors – some of which have nothing to do with the effectiveness of their prescribed treatments.
A few methods that I have witnessed patients use to judge competence of me (or other doctors) include: credentials, word of mouth from friends or family, receptiveness of the staff, and the doctor’s age.
A few weeks ago a patient that I saw expressed confidence in me because of my (young) age. He saw it as a plus because it signaled to him that I had recently completed training and was likely to be up to speed on the latest treatments.
Age can cut both ways for doctors. Some people will see a doctor’s young age and equate it with a better understanding of modern treatments. Others will see inexperience. Some will see older age doctors as being “out of date.” For others it will signify wisdom and experience.
I myself don’t know if age is a good heuristic or not for determining your doctor’s competence. I suspect I would use other criteria, but then again I have inside knowledge of doctors.
If I was to choose an orthopedic surgeon for myself or family member I would choose the doctor who has specialty training in the field that is relevant to my problem, is honest and explains all of my options thoroughly, has a good reputation among his or her peers for being a good doctor AND a good surgeon (there can be a difference), and -if I need surgery- someone who performs the particular surgery I need frequently. But that’s just me.
I can’t come to any conclusion about whether it is justified or not to choose a doctor based on whether they are young or old because I have seen patients choose both ways. I would bet that age can be a good proxy in some cases but not others. It just depends.