Little is known about the relationship between the physician age and the outcomes of the patients. A recent study investigated whether better clinical practices are performed by older physicians with increased experience or younger physicians with new up-to-date, hands-on training.
A study carried out at Harvard Medical School and published in the British Medical Journal researchers aimed to demonstrate a relationship with a physician’s number of years of practice and mortality in a population of elderly Medicaid patients. The observational study took place in US acute care hospitals, where 20% of Medicare’s fee-for-service male patients were assessed. These male patients were over 65 years of age and were admitted between the years of 2011 and 2014. The profiles of the physicians responsible for their care were obtained from hospital data and shift attendance sheets.
The researchers found that older physicians had significantly higher mortality rates compared to younger physicians. By substituting age with the number of years of practice, similar findings were observed. In addition to age, increased patient mortality was seen with physicians who had little or a medium number of patients. Surprisingly, the lowest death rate was associated with doctors who had a high number of patients. Physician age was, however, not associated with a high 30-day readmission rate. The authors had a hard time deducing whether the effect of age was due to a difference in treatment by younger and older physicians, as they were unable to quantify this aspect. The higher mortality rate seen with older physicians was noticed with the conditions of sepsis, congestive heart failure, and chronic obstructive pulmonary disease.
The researchers speculate that the positive correlation between increased physician age and mortality may be the result of two components: The age component, and the cohort component. The age component is a gap that is thought to be present because of the assumption made by the researchers, that as physicians age, they do not rely on evidence-based treatments, and their mode of therapy may be outdated. It is possible that older doctors are not up-to-date with the latest guidelines.
The cohort component reasons that younger physicians are well equipped with the latest medical knowledge. There is agreement that training has improved in the past few years, with the additional inclusion of technology to enhance medical services. Also, seen increasingly with younger physicians and health professionals is the development of multi-professional practice, increased adherence to guidelines, and developed safety culture at the hospital.
With these results, it is safe to say that in an effort to improve patient outcomes, hospitals should include programs to regularly update their physicians on the latest guidelines and technological advances.
Written By: Dr. Apollina Sharma, MBBS, GradDip EXMD