Physician Age and Patient Outcomes

February 27, 2018 7:02 am

Tsugawa Y, Newhouse JP, MacArthur JD, et al. Physician age and outcomes in elderly patients in hospital in the US: observational study. BMJ. 2017;357 doi: https://doi.org/10.1136/bmj.j1797

Thanks to Ben Gold for this reference. Slides from Patient Care newsletter.

Background:

Researchers used nationally representative data on Medicare beneficiaries admitted to hospital with a medical condition during 2011-14. They wanted to find out the association between age of the treating physician and 30 day patient mortality after admission; whether this association varied with the volume of patients a physician treats; and whether physician age is associated with readmissions and costs of care. Their study included 736 537 admissions managed by 18 854 hospitalist physicians (median age 41).

Key findings

The authors suggest a number of possible factors for their results. They divide these factors into “age” and “cohort” effects. One possibility is that older physicians far removed from training may not offer the most up-to-date evidence-based treatments. Another possibility is the revolution in hospital medicine. They point to the dramatic changes in training of recent cohorts of physicians who now work as hospitalists and note that their study might have compared younger physicians who began their careers as hospitalists with older physicians who began as primary care physicians and later became hospitalists.

My take: If medicine becomes a part-time job, patients may suffer. Physicians who remained busy and up-to-date did not have worse outcomes.

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