Hospital patients treated by older physicians are more likely to die

[xoxoxoBruce]

Hospital patients treated by older physicians are more likely to die

In a national sample of elderly Medicare beneficiaries admitted to hospital with medical conditions, we found that patients treated by older physicians had higher 30 day mortality than those cared for by younger physicians, despite similar patient characteristics. These associations were found among physicians with low and medium volumes of patients but not among those with high volumes.

[Griff]

Pro-tip: Don't choose a doctor with dementia.

[sexobon]

... Results ...
... Among physicians with a high volume of patients, however, there was no association between physician age and patient mortality. ...

... Strengths and limitations of study
Our study has several limitations. ...
... Second, we found that the positive association between physician age and patient mortality was driven primarily by physicians treating a low to medium volumes of patients, suggesting that high volumes could be “protective” of clinical skills. ...

... Conclusions
Within the same hospital, patients treated by older physicians had higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients. ...

... Moreover, while intense exposure to a large number of patients during residency training might enable physicians shortly out of such training to provide high quality care, the benefits of this training experience could wane if physicians care for fewer inpatients after residency. The lack of association between physician age and patient mortality among physicians with higher volume of patients supports this age related hypothesis. ...

It supports hypotheses for CME and proficiency maintenance relegating age consideration to the status of red herring as well. It's like with any other service provider, look for those who are getting a lot of business. If they're not, look at them more closely. If you're just looking at a service provider's age, you probably need help to make a wise selection.

... Our findings might just as likely reflect cohort effects rather than declining clinical performance associated with greater age, which has important implications for interpretation of our findings. Hospital medicine is among the most rapidly evolving specialties within medicine, with dramatic changes in the training of recent cohorts of physicians who now work as hospitalists, including greater emphasis on multi-professional team based practice, adherence to clinical guidelines, training on patient handoffs, familiarity with shift work during residency training, and an improved hospital safety culture. Because the specialty of hospital medicine was first recognized in the 1990s, our study might have compared younger physicians who began their careers as hospitalists with older physicians who began their careers as primary care physicians and later became hospitalists. Thus, cohort differences in physician training, as well as declines in skill with aging, could explain our findings. Under this hypothesis, the cohort of physicians entering hospital medicine today might experience no reduction in patient outcomes with aging or possibly improved outcomes. ...

... Policy implications
Our findings should be regarded as exploratory. ...

The findings are statistically significant; however, not necessarily for the reason one might think. They're not even close to being a statistical certainty and in practical application the study would not affect my choice in selecting a physician by age at all.

[xoxoxoBruce]

This finding agrees with an article I posted a year or two ago written by the head heart dude at the Penn system. Something like if you have a heart attack your chances of survival are better if the hospital's head doctors at at a convention.

[sexobon]

Don't let Dr. Oz mess with your ticker.

[xoxoxoBruce]

That quack is not a doctor, I don't care how many sheepskins he has.