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Study questions whether older doctors are wiser

An observational study published in the BMJ has investigated whether the outcomes of patients admitted to hospital differ between those treated by younger and older doctors.

The Harvard study was undertaken because the relation between a doctor’s age and performance remains largely unknown, particularly with respect to patient outcomes. Clinical skills and knowledge accumulated by more experienced doctors can lead to improved quality of care. Doctors’ skills, however, can also become outdated as scientific knowledge, technology, and clinical guidelines change.

The conclusion to the research suggests you’re likely to live longer when treated by someone under 40.

The researchers are keen to stress that their findings should be regarded as exploratory. Nonetheless, they highlight the importance of patient outcomes as one component of an assessment of how a doctor’s practices change over a career. The purpose of continuing medical education is to ensure that doctors provide high quality care over the course of their careers.

The study, performed at acute care hospitals in the U.S between 2011 and 2014, looked at patient readmissions, the costs of care, and deaths within 30 days of being admitted to the hospital.

The difference in patients’ 30-day mortality rates were 10.8 per cent when they were treated by a doctors under the age of 40, compared to 12.1 per cent for doctors aged 60 and up.

There was an exception: for older doctors who were treating high volumes of patients, age did not translate to higher mortality in patients.

Dr Yusuke Tsugawa, the study’s author said, older doctors bring experience because they’ve been practicing a longer time, but younger doctors have more current clinical knowledge.

“A lot of patients have a perception that older doctors give better quality of care. But previous studies, multiple studies, have shown that younger doctors have more aptitude. We found those treated by younger doctors had significantly lower mortality compared with those treated by older doctors,” Dr Tsugawa said.

Medical technologies are evolving all the time and it might be harder for older doctors to keep up with the evidence. And new guidelines are updated every five to 10 years. Newer doctors train based on the newest evidence and skills and technologies. Therefore, they may be more up-to-date when they start providing care.”

Meredith Horne

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