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    Do younger doctors outperform older physicians?

    Do patients prefer Marcus Welby, MD, or Derek Shepherd, McDreamy, for their physician? The former, a well-seasoned veteran of medical science, the latter, a recently educated young doctor?

     

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    Your patient’s preferences may make more of a difference than your bedside manners. Or not.

    Researchers at Harvard found that the patients of older physicians have a higher mortality rate than those of their younger colleagues.

    The observational study, which was published in the British Medical Journal, looked at 700,000 patients treated by 19,000 doctors from 2011 to 2014 and found a rise in the mortality rates of the patients as the age of their doctors increased.[1]

    All patients in the study were 65 and older and on Medicare. Patients with doctors under 40 had a 30-day mortality rate of 10.8% while patients of docs aged 41-49 had a mortality rate of 11.1%. Physicians aged 50-59 had a patient mortality rate of 11.3%, and once doctors were older than 60, their patient’s mortality rate rose to 12.1%.

    Adjustments were made for patient’s age, sex, race, comorbidities, household income and day of admission.

    What would account for the jump in mortality rates from doctors under 40 to those over 60? Technology? Training? Continuing education?

    “There are so many obvious and not so obvious reasons why the conclusions may be completely false—even the opposite—of what was observed that perhaps a real study of the question may give a better answer,” says Stuart Spitalnic, MD, an emergency medicine physician at Newport Hospital and clinical assistant professor of Emergency Medicine at Brown University.

     

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    Spitalnic says, “The authors themselves point out this could, if any relationship existed at all, be explained by a cohort effect.” Cohort effect commonly occurs in research when the similarities among study participants effect the study results.

    Next: Are we pitting young doctors against their mentors?

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