Results of a new study reveal that patients treated by hospitalists are more likely to die within a month of admission as compared to those treated by younger physicians. The study was led by researchers at Harvard Medical School and Harvard T.H. Chan School of Public Health and the findings are published in BMJ.
During the study, the investigators analysed over 730,000 hospital admission records of Medicare patients, age 65 and older and treated by more than 18,800 hospitalists.
Their findings reveal the largest gap in patient mortality between hospitalists 40 and younger and those 60 and over. The researchers found differences in death rates - 10.8% among patients treated by younger physicians compared with 12.5% among patients treated by older physicians.
While this appears to be a modest difference, it actually translates into one patient death for every 77 patients treated by older physicians as compared to those treated by younger physicians. However, the researchers note that physician age made no difference in mortality outcomes for doctors who managed large numbers of patients. This suggests that the more patients the doctors treat, the more likely they are to maintain their clinical skills.
As first author Yusuke Tsugawa, a researcher in the Department of Health Policy and Management at Harvard T.H. Chan School of Public Health explains, residency training helps sharpen the clinical skills of new doctors and exposes them to a variety of cases but when physicians get away from residency, their clinical skills tend to decline. As long as they keep treating high volume of patients, their skills remain consistent.
Mortality rates were less pronounced when comparing physicians in their 40s and 50s but death rates increased as physicians got older. This difference persisted even after accounting for patients' age and severity of their medical condition. Also, readmission rates were not affected by physician age but the cost of care was higher among older physicians.
“Older physicians bring invaluable richness of knowledge and depth of experience, yet their clinical skills may begin to lag behind over time,” says senior investigator Anupam Jena, the Ruth L. Newhouse associate professor of Health Care Policy at Harvard Medical School and an internal medicine physician at Massachusetts General Hospital. “The results of our study suggest the critical importance of continuing medical education throughout a doctor’s entire career, regardless of age and experience.”
There is no doubt that the experience older physicians have can boost cinical performance but with rapidly changing technology, emerging scientific evidence and changes in clinical guidelines, it may be challenging for these physicians to keep up and incorporate these changes in their practice. That is why the authors believe that continuing medical education courses could play an important role in keeping these physicians abreast of all important changes throughout the span of their professional lives.
Source: Harvard Medical School
Image Credit: Pixabay
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mortality risk, Physician Age, hospitalists, clinical skills
Results of a new study reveal that patients treated by hospitalists are more likely to die within a month of admission as compared to those treated by younger physicians.
