WSJ: Do Younger or Older Doctors Get Better Results? Save
A recent Wall St. Journal essay (by AB Jena and C Worsham) suggests that a physician’s effectiveness has less to do with age than with how many patients they see and how well they stay up to date on research.
If admitted to the hospital would you rather your physician be in their 50s, or in their 30s, just out of residency or fellowship?
Patients often choose their doctors based on bedside manner, perceived expertise, responsiveness, and other subjective attributes. However, when hospitalized, doctors are often assigned based on schedule and problem.
A Medicare study looked at 737,000 non-elective hospitalizations managed by 19,000 different hospitalists between 2011-13. Outcomes were analyzed based on doctors age - less than 40, 40-49, 50-59, and 60 and above.
- Older doctors had more years of experience than those under 40 yrs.
- Older doctors were more likely to be male: 61% of doctors under 40 were men, compared to 84% of doctors over 60
- Older doctors had higher mortality rates ( compared to under-40 doctors (10.8%), 40-49 yr doctors (11.1%), 50-59 (11.3%) group.
When outcomes were looked at based on age and case volume, they found “low volume” doctors, older doctors had higher mortality. For “medium volume” doctors, the pattern was less pronounced. And for “high-volume” doctors, the pattern went away altogether. In practical terms, as long as a doctor is seeing a sufficiently large number of patients, the doctor’s age is irrelevant to the care they give.
Another analysis of 900,000 Medicare patients undergoing non-elective major surgeries found the opposite. Unlike hospitalists, surgeons got better with age. Patient mortality rates were 6.6% for surgeons under 40, vs. 6.3% for surgeons over age 60.
Are age and experience important to outcomes? Important to patient selection?
A followup WSJ article accumulated many patient comments and opinions (read here for more).