Young doctors flock to new specialty – End-of-life care

April Dembosky | 2/14/2012, 5:40 p.m.

About 12 percent of the doctors certified in hospice and palliative care in 2010 are now 36 or younger, according to the latest data available from the American Board of Medical Specialties. That percentage doubled in two years and is expected to dramatically grow under new rules that prevent older doctors from being grandfathered into the specialty. Starting this year, doctors must complete a one year training fellowship in palliative medicine, a position that offers a meager salary that few older mid-career doctors will opt for.

Stanford’s fellowship program is one of about 70 similar programs formed in recent years, and among the first launched.

As much as they gain medical skills and knowledge, trainees say they learn how to handle themselves with patients, either by assuming the role of a grandchild or just being humble.

“Sometimes it is scary to know you are much younger than your patient,” said Domingo Maynes, 30, a resident with the program. “But by putting myself in their shoes and talking to the family, I can start to wrap my hands around the intangibles.”

A Sympathetic Ear

For some patients, a doctor’s youth doesn’t matter.

“I’m not interested in what their age is” said Warren Harding Atkins, 93, who gets treated for severe back pain at the Palo Alto VA. “I want them to find solutions to my problems.”

Atkins tells stories of working in the merchant marine during the 1940s, once delivering a baby on board his ship in the middle of the sea with no medical help. While he bemoans his grandchildren’s generation for not appreciating what they have or learning from history, he is happy with the young doctors looking after him.

“They listen to me, and that’s all I need,” he said.

If anything, the young doctors say their generation is particularly well suited to this kind of care, especially at these early stages of the field when hospitals across the country are opening brand new hospice and palliative care departments.

“This is a generation that grew up hearing about startups and innovation,” said Stephanie Harman, 35, who helped launch the Hospice and Palliative Medicine fellowship at Stanford. “The idea of the specialty of palliative care being a new field, with a lot of opportunity to innovate, and work in a team structure, that’s something this generation is much more primed to do and excited about.”

Editor’s Note: The following was written under a MetLife Foundation Journalists on Aging Fellowship in partnership with New America Media and the Gerontological Society of America.