Patients treated by older physicians had higher mortality than patients cared for by younger physicians, with the exception of those physicians treating high volumes of patients, according to a recent observational study that assessed mortality outcomes in elderly patients in a single hospital. A total of 736,537 admissions were managed by 18,854 hospitalist physicians (median age 41) and patients’ characteristics were similar across physician ages. Researchers found:
- After adjustments, patient adjusted 30-day mortality rates were 10.8% for physicians aged <40 years, 11.1% for physicians aged 40-49 years, 11.3% for physicians aged 50-59 years, and 12.1% for physicians aged ≥60 years.
- However, among physicians with a high volume of patients, there was no association between physician age and patient mortality.
- Readmissions did not vary with physician age.
Tsugawa Y, Newhouse JP, Zaslavsky AM, Blumenthal DM, Jena AB. Physician age and outcomes in elderly patients in hospital in the US: Observational study. BMJ. 2017;357:j1797. doi:10.1136/bmj.j1797.
Evidence changes rapidly in medicine and it is challenging to stay up-to-date once one has left residency training. That patients of older physicians (particularly physicians over age 60) may have increased mortality is concerning, and could possibly be related to older physicians not incorporating changes in evidence and recommendation as readily as do younger physicians. As the amount of new evidence can be overwhelming, it is important for physicians in all stages of their careers to develop sound strategies for lifelong learning and to keep up with changes in medical practice. —Neil Skolnik, MD
This Week's Must Reads
Must Reads in Geriatrics
Site of Death & Patterns of Care in Older Adults, JAMA; ePub 2018 Jun 25; Teno, Gozalo, et al
Psychological Interventions & Chronic Pain Reduction, JAMA Intern Med; ePub 2018 May 7; Niknejad, et al
Home-Based Exercise & Walking Performance in PAD, JAMA; 2018 Apr 24; McDermott, Spring, et al
USPSTF Recommendation on Falls Prevention, JAMA; ePub 2018 Apr 17; US Preventive Services Task Force
Guidelines for Geriatric Diabetes Care, J Am Board Fam Med; 2018 Mar-Apr; McCreedy, et al