Older doctors a lot more tech-savvy than many think

A practical look at information technology issues and usage

By Pamela Lewis Dolancovered health information technology issues and social media topics affecting physicians. Connect with the columnist: @Plewisdolan  —  Posted Dec. 19, 2011.

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The most experienced (read: oldest) physician in the office is often assumed to be the least tech-savvy. In reality, the opposite may be true.

Even though older physicians have been found to be the least likely to adopt an electronic medical record system, it's not because they're averse to technology, analysts say. It's likely that their experience may have taught them not to be so quick to cling to a new fad, or spend money on something that will make them less efficient. But if you offer them something they think will make them better doctors, they will use it enthusiastically.

"People keep talking about waiting for this older generation to move out of medical practice before we can innovate," said Jeffrey Linder, MD, MPH. "And we don't necessarily need to do that. We have great innovative capabilities among doctors of all ages."

Dr. Linder, associate physician at Brigham and Women's Hospital in Boston and an assistant professor of medicine at Harvard Medical School, co-wrote a study that looked at the characteristics of physicians who were more likely to use advanced features of the EMR system at Brigham and Women's. The research, published online Sept. 7 in the Journal of the American Medical Informatics Assn., found that physicians more than 10 years out of medical school and those with higher patient volumes were more likely than younger and less busy physicians to use advanced EMR features.

A doctor's patient load was a more dominant predictor than age, but busier doctors also tended to be older, Dr. Linder said.

Results of the study ran counter to conventional wisdom that older physicians are less likely to try out advanced features of an existing EMR. The experience older doctors have in the art of medicine may give them greater confidence to add something new to their practice, Dr. Linder said.

"They are not having to rack their brains to do basic stuff that younger doctors might be doing, so they are operating medically and mentally at a higher level and are able to attend to new stuff in the electronic medical record," he said.

Because the study looked at physicians who were using a system that has been in place for more than a decade, what this means for new EMR implementations is a little less clear. It does, however, offer a glimpse of how physicians view the role of technology in medicine, analysts say.

Dean Sittig, PhD, professor at the School of Biomedical Informatics in The University of Texas Health Science Center at Houston, said physicians have never been averse to technology. "They are averse to things that don't help them get their work done."

Experienced physicians have become quite comfortable with how they have practiced medicine for so many years and aren't actively looking for ways to change. But if they find a product they think will help them, they are open to adopting it.

Sittig said older physicians are starting to see how technology can help them be more effective. He used the example of older doctors taking a liking to smartphones and tablet computers.

A June survey of 3,798 physicians by QuantiaMD, an online learning collaborative, found that physicians who have been in practice 31 years or more are about as likely as those fresh out of medical school to own a tablet computer. Many doctors adopted the devices because they offer efficiency in allowing access to information from anywhere.

Erica Drazen, managing director of the Emerging Practices Group in the health care division of the Falls Church, Va., research group CSC, said one- and two-physician practices (a high percentage of which are run by older doctors) have greater barriers than others when it comes to adopting an EMR. These barriers -- cost being No. 1 -- left physicians hesitant to jump in. The barriers are starting to come down, but physicians want to make the right decision.

Arnold M. Koff, MD, 79, an internist in Avon, Conn., believes that attitude, not age, influences technology decisions. He has been using an EMR system since 1998, when he built his own using spreadsheets and a word processing program.

Dr. Koff said that at one point he hired two nurse practitioners: one 75, the other 35. He said the 75-year-old took to the EMR right away and the 35-year-old "didn't want to be bothered."

The difference, he said, was "an attitude about learning something new."

Pamela Lewis Dolan covered health information technology issues and social media topics affecting physicians. Connect with the columnist: @Plewisdolan  — 

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External links

"Clinician characteristics and use of novel electronic health record functionality in primary care," Journal of the American Informatics Assn., published online Sept. 7 (link)

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