Can a physician's age affect treatment outcome? It did in this study of hospitalized elderly patients.
Do outcomes of hospitalized elderly patients differ depending on the age of their treating physician? Tsugawa and colleagues1 published the results of their investigation into this question in the British Medical Journal. A synopsis follows.
Researchers used nationally representative data on Medicare beneficiaries admitted to hospital with a medical condition during 2011-14. They wanted to find out the association between age of the treating physician and 30 day patient mortality after admission; whether this association varied with the volume of patients a physician treats; and whether physician age is associated with readmissions and costs of care. Their study included 736 537 admissions managed by 18 854 hospitalist physicians (median age 41).
Patients whose treating physician was ≥60 had significantly higher 30-day mortality rates than did those who had a younger treating physician.
There was no association between physician age and patient mortality among physicians with a high volume of patients. Readmissions did not vary with physician age, but costs of care were slightly higher among older physicians.
The authors suggest a number of possible factors for their results. They divide these factors into "age" and "cohort" effects. One possibility is that older physicians far removed from training may not offer the most up-to-date evidence-based treatments. Another possibility is the revolution in hospital medicine. They point to the dramatic changes in training of recent cohorts of physicians who now work as hospitalists and note that their study might have compared younger physicians who began their careers as hospitalists with older physicians who began as primary care physicians and later became hospitalists.
In this study, outcomes among hospitalized elderly patients had a direct correlation with the age of the treating physician. Several possibilities may explain this finding.
1. Tsugawa Y, Newhouse JP, MacArthur JD, et al. Physician age and outcomes in elderly patients in hospital in the US: observational study. BMJ. 2017;357 doi: https://doi.org/10.1136/bmj.j1797