The older the doctor, the higher the patient mortality rate, study finds

According to a study by Harvard researchers, patients of older physicians have a higher mortality rate than those of their younger colleagues.

Their observational study of 737,537 USA hospital patients and the 18,854 doctors who treated them has found that those seen by a doctor over 60 have a higher chance of dying within the next 30 days than if they are treated by a doctor under 40.

Researchers from Harvard T.H. Chan School of Public Health in Boston analyzed data from a random sample of more than 736,000 Medicare patients ages 65 and up whose cases were managed by 18,854 hospital physicians.

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.

Nevertheless, they conclude that "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 patient volumes".

Older doctors who saw high volumes of patients didn't see their patients' mortality rates increase.

They found that among doctors with a high volume of patients there was no association between physician age and patient mortality.

Researchers did find, however, that patient death rates slowly increased as doctors aged. That allows for a degree of randomization of patients to doctors of varying age, which allows us to better elucidate what is the potential impact of a doctor's age on patient outcomes. Moreover, while the age-related mortality trend was significant overall, it ceased to assert itself when researchers sorted doctors by caseloads. Multivariable logistic regression model with linear splines was used with knots placed at physician age of 40, 50, and 60, adjusted for patient and physician characteristics and hospital fixed effects.

Contrary to popular wisdom, an older, more experienced doctor may not always be the best choice. Additionally, the analysis focused on one subspecialty-hospitalists-and the findings may not apply to other specialists.

"Medical technologies are evolving all the time and it might be harder for older doctors to keep up with the evidence", added Tsugawa, who also headed a study that said the patients of female doctors were four percent less likely to die than those treated by men.

"Older physicians bring invaluable richness of knowledge and depth of experience, yet their clinical skills may begin to lag behind over time". "The results of our study suggest the critical importance of continuing medical education throughout a doctor's entire career, regardless of age and experience". For instance, doctors' skills may deteriorate over time - or simply become outdated, and older doctors may be more likely to rely on anecdotal rather than evidence-based practices.

All the more reason that "patients should be more-informed consumers in selecting a hospital", Aiken advised.

Vanessa Coleman

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