When asking about a doctor’s credentials, you may also want to note his or her age — older physicians are tied to a higher death rate among hospital patients, shows a new study.
While the study authors, reporting from the Harvard School of Public Health and other organizations, caution that their findings are “observational” and not necessarily a cause-and-effect situation, they warn that older doctors may be out of touch with current guidelines and standards.
“Older physicians have decreased clinical knowledge, adhere less often to standards of appropriate treatment, and perform worse on process measures of quality with respect to diagnosis, screening and preventive care,” write the study authors in the British Medical Journal.
Overall, the researchers reviewed data on more than 735,000 hospital admissions in the U.S. over the three-year period from 2011 to 2014. The admissions involved nearly 19,000 physicians across a wide age range. The physicians’ median age was 41.
After crunching numbers related to health outcomes, the researchers discovered a strong association between a doctor’s age and the chance of death among patients.
“After adjustment for patient and physician characteristics and hospital fixed effects, older physicians had significantly higher patient mortality than younger physicians,” report the researchers.
The chance of mortality associated with a doctor’s age was on par with some clinical intervention, such as medications.
“This difference in mortality is comparable with the impact of statins for the primary prevention of cardiovascular mortality on all-cause mortality,” report the authors.
Again, while the results are associative, the researchers paint a dire portrait of care should further studies prove a causal relationship. Should studies confirm that link, the numbers suggest “that for every 77 patients treated by doctors aged ≥60, one fewer patient would die within 30 days of admission if those patients were cared for by physicians aged <40.”
In other words, patients treated by a physician under the age of 40 have an 11 percent decreased risk of dying than those treated by a doctor over the age of 60.
Taking a Closer Look
An accompanying editorial casts a harsh light on the ability or willingness of older physicians to stay in line with current industry standards, which may have changed significantly over the course of one’s career.
“Besides this study, 74% of studies evaluated in a systematic review found a partially or consistently negative association between physician age and adherence to recommended treatment, leading to a conclusion that quality improvement interventions in the form of continuing education should be explored,” writes Linda Aiken, the Claire M. Fagin Leadership Professor of Nursing at the University of Pennsylvania, in an accompanying editorial.
The Harvard researchers believe that a doctor’s skills — and thus a patient’s health outcomes — should be carefully considered.
“Clinical skills and knowledge accumulated by more experienced physicians can lead to improved quality of care. Physicians’ skills, however, can also become outdated as scientific knowledge, technology, and clinical guidelines change,” report the Harvard researchers.
For Aiken, the study may be a call to action for the medical community to address an important quality issue.
“While a single study rarely provides definitive answers to complex questions, this one succeeds with new considerations about an old topic – namely, if provider age is associated with clinical performance, what are the options for ensuring that quality and safety of care is optimized for patients?” adds Aiken.
Richard Scott is a health care reporter focusing on health policy and public health. Richard keeps tabs on national health trends from his Philadelphia location and is an active member of the Association of Health Care Journalists.