The study led by Yusuke Tsugawa had investigated the relationship between patient mortality and doctor age by analysing the random data collected from more than 700,000 hospitals from 2011 to 2014. The patients received treatment from whichever physicians who were on duty at the time of their admission.
While studying nearly 19,000 doctors who treated the patients, the team found that the patients treated by a doctor aged 60 or over had a noticeably higher chance of dying within a month, as compared to those who saw a doctor younger than 40.
“There’s a fear that as doctors get further away from residency, they might be out of touch with new technologies and treatments,” said the senior author, Dr Anupam Jena.
The older the doctor, the higher the patient mortality rate
Although there is an assumption that older doctors tend to provide better care than their younger colleagues, due to their superior clinical experience; the new study showed that newer doctors who have undergone training more recently make safer decisions.
In the study, the researchers discovered that the patient mortality rate was 10.8% when treated by physicians below the age of 40; whereas for physicians aged 50 to 59, the mortality rate was 11.3%. Surprisingly, the mortality rate rose just above 12% for physicians over 60 years old.
“Older physicians bring invaluable richness of knowledge and depth of experience, yet their clinical skills may begin to lag behind over time,” said Jena.
One interesting point to note, however, is that doctors – regardless of age – who treated large numbers of patients had a rather constant patient mortality rate.
“It could be that high-volume doctors are experiencing no decrease in their skills or expertise,” he said. “Maybe low- to medium-volume doctors just don’t see enough patients to have to keep up. Or maybe those doctors are less knowledgeable, so they see fewer patients. It’s not clear what comes first.”
The concern for dementia in older healthcare professionals
In the meantime, this study corresponds with the recent concern raised over the capability of nurses or other healthcare professionals, who are diagnosed with dementia, to continue caring for patients.
The Royal College of Nursing (RCN) and the profession’s trade union urged the health service to set an example to the society by supporting the continuous service of staff with degenerative conditions, but the safety groups condemned the proposal as “frightening and extraordinary”.
Amid the controversy between the union and the safety campaigners, the chief executive of NHS Employers, Danny Mortimer, said, “This is an extremely sensitive issue and must be given due consideration before any changes are implemented.”
"We would encourage employers to have open conversations with their staff about this issue, and consider engaging with initiatives such as Dementia Friends, which can help to develop dementia-friendly work places. This is important both for our staff and our patients."
A need for continuing education throughout medical career
Even though the researchers emphasised that their findings were purely observational, and no firm conclusions should be drawn yet – the study reflected the presence of outdated training and that “specific interventions could be targeted towards these physicians”.
“The results of our study suggest the critical importance of continuing medical education throughout a doctor’s entire career; regardless of age and experience,” said Jena. MIMS
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