18 May, 2017
Patients in United States hospitals treated by older physicians have higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients, finds a study published by The BMJ today. Patient mortality was seen to be 1.3 percent different between physicians aged 40 and younger (10.8 percent death rate) compared to physicians 60 years old and above (12.1 percent death rate).
The researchers go on to say that physician age was found to make no difference in mortality outcomes for those who managed a large number of patients.
The team of US-based researchers analysed the association between physician age and whether a patient died within 30 days. That difference translates into one additional patient death for every 77patients treated by physicians 60 and older, compared with those treated by doctors 40 and younger.
This suggests, they conclude, that older doctors more removed from residency training may need regular refreshers to keep their clinical skills sharp if they treat relatively small numbers of patients. When a doctor was between 40 and 49 years old, the patient mortality rate was 11.1%.
"Our team was not surprised by the findings", said study lead author Dr. Yusuke Tsugawa, a research associate at the Harvard T.H. Chan School of Public Health.
The first is that as physicians age and accumulate experience, their outcomes can improve because they see more and more patients and they have a better idea of how to diagnose and treat disease.
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The researchers caution that their study is strictly observational, showing only a link, rather than cause and effect, between physician age and patient outcomes.
Doctors were assigned patients based on work schedules and case specifics, with assignment protocols deemed comparable across all physician ages.
Even as these older physicians retire, there will be an even bigger problem facing the nation - there won't be enough younger doctors that could take their place. Additionally, the analysis focused on one subspecialty-hospitalists-and the findings may not apply to other specialists.
"Older physicians bring invaluable richness of knowledge and depth of experience, yet their clinical skills may begin to lag behind over time", said study co-author, Professor Anupam Jena.
The link between clinical performance and physician age has long fascinated doctors, health care policy researchers and social scientists alike.
"Medical technologies are evolving all the time and it might be harder for older doctors to keep up with the evidence", added Tsugawa, who also headed a study that said the patients of female doctors were four percent less likely to die than those treated by men.
All the more reason that "patients should be more-informed consumers in selecting a hospital", Aiken advised.