Article written by 2016 Abe Fellow Yusuke Tsugawa based on his project “Assessing variation in physicians’ practice patterns and its impacts on quality of care and healthcare spending in the U.S. and Japanese contexts.”
The relation between physician age and performance remains largely unknown, particularly with respect to patient outcomes. 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 Physicians’ skills, however, can also become outdated as scientific knowledge, technology, and clinical guidelines change. Incorporating these changes into clinical practice is time consuming and can at times be overwhelming.123 Interest in how quality of care evolves over a physician’s career has revived in recent years, with debates over how best to structure programs for continuing medical education, including recent controversy in the US regarding maintenance of certification programs.
A systematic review of the relation between physician experience and quality of care found that older physicians might perform worse—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.4 Data on patient outcomes, which arguably are most important, have been scarce.4 Existing studies have also been limited in size or disease scope and have not been nationally representative.567 As a result, whether physician age is associated with patient outcomes remains largely unknown.
Using nationally representative data on Medicare beneficiaries admitted to hospital with a medical condition during 2011-14, we sought answers to three questions. First, what is the association between age of the treating physician and patient mortality after admission? Second, does this association vary with the volume of patients a physician treats? Finally, given national efforts to improve the efficiency of healthcare, is physician age associated with readmissions and costs of care?