CAMBRIDGE, Mass. — If you could choose your doctor, would you prefer youth or experience? You might pick the fresh-faced physician if you consider that patients in hospital settings are more likely to die when treated by doctors who are at least 60 years old, according to a recent study.
Researchers at Harvard wanted to know how well physicians perform as they age. They looked at the records of 730,000 Medicare patients treated between 2011 and 2014 by more than 18,800 hospital-based internists (hospitalists).
Patient deaths rose gradually as physicians aged, but the biggest gap —1.3 percentage points —showed up between hospitalists 40 and younger and those 60 and older. This means one additional death for every 77 patients admitted by a doctor who is 60 or older versus a doctor who is 40 or younger.
Study senior investigator Anupam Jena, an associate professor of Health Care Policy at the university and a physician at Massachusetts General Hospital, says this outcome raises some serious concerns.
“It is comparable to the difference in death rates observed between patients at high risk for heart disease who are treated with proper heart medications and those who receive none,” she explains in a Harvard Medical School release.
There is a bright spot, however, in all this aging gloom and doom. When physicians carry heavy caseloads, physician age is not a factor in patient mortality. Researchers believe that caring for large numbers of patients keeps a doctor’s skill set strong.
Older doctors may have knowledge that can only be gained by experience, but they cannot just rest on their laurels. They have to keep up with the rapid changes that come with new research and technology.
“The results of our study suggest the critical importance of continuing medical education throughout a doctor’s entire career, regardless of age and experience,” Jena says.
Researchers say this study is too limited to draw any final conclusions about how older physicians perform on the job. They would like to look into what else might be influencing the higher mortality rates in patients cared for by older doctors.
Perhaps, in answer to the first question posed, your best bet is to choose the busiest doctor.
The study’s findings were published in The BMJ.
I’ll take the old Doc who’s seen it all.
A true non sequitur, as older doctors tend to serve an older population in more rural areas, and at community hospitals with lower acuity ratings, rather than city teaching hospitals with higher trauma ratings. Add to this that most older patients have a DNR which precludes resuscitation and increases mortality. Basically, this is a bullshit report.
DNRs aren’t invalid in the ER. However, many patients don’t bring the DNR with them or their family doesn’t abide by the patient’s wishes.
You are Correct. A family member saying there is or isn’t a DNR does not qualify.
They are, hargen. I’m a retired RN, this is hospital policy and law nationwide.
I thought so, thanks for the professional first hand report. The original poster that DNRs weren’t valid in the ER.
What did you say Dr. Khan? I can’t understand you…
A recent study showed that if you pump a gallon of milk into a laboratory rat, it will explode.
Laughable study.
I want to see the data on that, lol.
Also, another study showed that as the water table declined the consumption of peanuts and cracker jacks increased, and surprisingly, another revealed that most places on the globe out of view from the sun had the most sleepiness associated.
Read on idiots.
Older patients have probably been with their doctor for many years, that makes the doctor older and older patient more likely to die.
“Researchers say this study is too limited to draw any final conclusions about how older physicians perform on the job…” Priority #1 – speak clear English to your potential patients.
I’d be curious to know if they took into account the age of the patient. Older doctors are more likely to be treating older patients, who may have treated much of their lives, I would suppose, in many instances.
Hence, you’re going to have more death among older patients. Did anyone else that they brought that up in the article?
Older patients have more age related problems – not the DR’s fault! ( You really don’t want to be in the Hospital when you’re sick. ) The young kids don’t have the background / experience of an older Doc, and probably tend to more strictly adhere to Gov’t guidelines – like NOW B/P 130/70, 2 weeks ago 140 / 75. Wife’s heart doc – It’s just a number – always HIGH when taken by the new young assistants who slap an Omiron cuff , poke the button, and then talk while getting your BP. Rarely can they take it manually. Anyhoo, 1.3% diff?? Wow. OK outahere.
I think there is a huge integrity problem. I just learned last night that my brother’s doctor kept prescribing lamictal to him even after multiple severe rashes that my brother never told me about that are probably stevens johnson.
I saw a young doctor rescusitating a terminal patient for the 29th time that night, and finally pulled him through brain dead and on a ventilator. Is this what you mean?
Agreed. Some younger physicians are focused on resuscitating a patient to have a heart rate, BP and respiratory rate (well even a vent rate will do). I fell younger physicians are taught that; as well as nurses, paramedics and PAs. Until one works or walks through a vent hospital, or watch one of the “saves” live on a vent for weeks -or longer- in the place they finally die, do we come to understand sometimes letting a person die is best for the families and patients.
Wisdom and experience….
Once CPR is started, it would be unethical and illegal to stop until the patient is surely and completely dead.
Once CPR has started they are dead. You’re not going to kill that dead guy/gal.
Auto mechanics doesn’t apply to the medical world. The law states that if you start a rescue of any kind and stop in the middle, and the victim dies, you are guilty of wrongful death. If anyone, medical or not, starts CPR, you cannot legally quit until they are officially deemed dead by a physician; this doubly applies to licensed medical personnel. This is my understanding as a retired RN and Paralegal.
You are wrong. Sorry
“retired RN and Paralegal”
Bingo!
In the industry, that’s what’s known as a Legal Nurse Consultant (LNC). LNCs are great at risk analysis and regulatory compliance. Even show up to court as an expert witness in civil suits involving nurses. There’s a wide world out there in the field of nursing, you should look into becoming one.
LOL Given I have already earned my MD and MSPH, a JD the cheapest way to earn a seat for the state Bar exam is the only possible interest to me. And then my interest would be in intellectual property not mucking around in malpractice or domestic law.
Yeah, you have all this time on your hands to make silly posts being poly-doctorate. Say hello to your mother next time she brings down your PBJ sandwich to your basement “apartment”, as she’s gotta be a saint.
LOL Bet you were a real treat to have taking care of grandma. /s/
The lady you visit once a year in the nursing home, and yell at the staff for not paying her enough attention? You’re that guy.
The one you were too lazy to help with scheduled toileting and let get the decubitus started on your watch no doubt.
So you’re a failed CNA. SMH.
LOL Ice will help that exposed nerve you have.
I’ll give you the last trollish word, Spanky.
Work on getting a real degree instead.
This kind of assumption ends at the ER doors, where all bets are off and DNR is invalid.
A DNR when present is valid in the ED at the nursing home and in the field.
I’m not 100% sure the laws in all states are the same, but the states I know, a signed DNR is valid when presented at time of end of life.
Yes, at nursing homes, in the field, on the floor, but not in the ER. The industry doesn’t want medical professionals second guessing themselvelves in that setting. This is nationwide.
I’ve seen DNR shut down CPR on numerous occasions in the ED.
A doctor calls it. That’s not a DNR.
I’ve seen DNR stop cpr in private homes.. no doctor around. I’m sorry, you simply do not know why you are talking about. Maybe your assertions were true years ago, but not now.
Yes, by EMTs in a home. No, by a doctor or nurse in the ER. Now, not years ago.
A doctor would not keep the wishes of a dying person with a DNR? Highly unlikely.
Umm, remember Annie, Annie, are you all right? No breathing, no pulse… call 911 or call a code bc with no breathing and no pulse – he/she is dead. So calling the code doesn’t make him/her more dead.
For legal and ethical reasons, medical professionals approach it a bit differently.
“medical professionals”? Not talking physician, eh?
Of course I am.
Parsing definitions to no end.
Hospitalists usually work 12 hour shifts. A hospitalist is basically the floor doctor for hospital patients.
As a retired hospitalist/intensivist I can promise you our shifts rarely ended with prompt 12 hour clock outs. Most of us on the floor and in the ICUs did what we needed to tuck our patients before handing over their care – with that often entailing staying later than our “shifts”. The ones that left unstabilized patients bc their “shift” was over are not the ones I want caring for me or mine but that’s all there will be soon enough. Count yourself lucky if you can understand them when they blow through.
Most people don’t understand the term “hospitalist”, just pointing that out.
I think older patients tend to stick with their older doctors. Older patients are more likely to die at any time than younger patients.
So again just more fake news that liberals think is “Science”
Researchers say this study is too limited to draw any final conclusions about how older physicians perform on the job.
Fake news
I think a lot of older doctors get tired and worn out. They just don’t care anymore. I seen that when my mom was sick and then passed away. To be fair, the younger doctors and nurses didn’t seem that concerned about her either. When you are old you get treated badly. I had always heard that. Didn’t believe it until I witnessed it with my mom.
That is what experienced doctors deal with every day. Recognizing and communicating futility to family members who don’t understandably see it. Not the doctors fault – just part of the job.
That is just stupid. Don’t even go there. If you think telling a dying woman all the scary details of her dying is what an experienced doctor does, then you are an idiot. The women knew she was dying. She didn’t need to know all the sicking details of how it was happening. Talking about her like she wasn’t even in the room. If you are a doctor or healthcare professional, then you are a sorry one.
Did you read what I wrote. Communicating to family members and ultimately honestly with the patient – do you think that is not appropriate? News to you – you will die someday and you will want someone experienced to assist you.
Did you read what I wrote? Did I at any point insinuate that we, or her, did not understand she was dying and options were limited? I don’t think so. We knew she was dying. She didn’t want to be kept alive in her state. My whole point was they way they treated a dying woman. They were crude, insensitive, saying all kinds of scary things about organs shutting down and all that shit. We knew that! She knew that! Why keep reminding everybody! Why keep talking about her like she wasn’t in the room? They weren’t talking to her; they were talking about her! Laughing with each other about conversations that had nothing to do with the job, and not an ounce of empathy about how she felt. She had a lot of sorry a** doctors and nursing staff. There were also so really great ones. Like the ICU nurses. Outstanding! They had a clue about was going on and how to treat a dying person. Too many hospital staff are sorry losers when it comes to treating the human side of a person, and odds are you are too.
My grandfather joked quite a bit about his pending death, and his doctor reflected his attitude. Freaked my aunts out.
It doesn’t matter when doctors have a heavy load because then everybody dies. This is the case in all the US hospitals I’ve seen. “Hospitalists” and nurses are hard working, or so they say, because you can’t find either.
Older doctors tend to have older patients. Is that reflected in this study or the next one?
I’ll take the Asian dude…Sorry! Not sorry!
And how was this study controlled for they likely hood that a doctor’s patients age at the same he does.