Old doctors may not die, but more of their patients do
US study shows patient death rates increase with hospital physician’s age, writes Andrew Masterson.
A team of researchers led by Yusuke Tsugawa of Harvard University, in Boston, set out to measure the relationship between patient mortality and doctor age by crunching the numbers on 736,537 elderly US hospital patients and the 18,854 doctors who treated them.
Tsugawa’s team looked at mortality, readmissions and cost of care for the patients, aged 65 and older, in the 30 days after they were admitted to hospital.
Among patients treated by hospital physicians under the age of 40, 10.8% died; for doctors aged 40 to 49, the figure was 11.1%; for doctors aged 50 to 59, it was 11.3%; and for doctors aged 60 or more, 12.1%.
To put it another way, for every 77 patients who died when treated by doctors over 60, only 76 died when treated by medicos under 40.
The researchers stress their results are purely observational and no causal relationship between doctor age and patient relationship can be inferred. Indeed, the study also found that in doctors with a high volume of patients mortality rate did not differ with age.
They also point out that doctor age is only one potential variable governing patient health, and that considerable variation in treatment outcomes was found within each age range examined.
However, they do suggest the higher mortality rate in patients treated by doctors over 60 might reflect outdated training, and that “specific interventions could be targeted towards these physicians”.
In an accompanying editorial, Linda Aiken and Joshua Dahlerbruch of the School of Nursing at the University of Pennsylvania note that, in addition to the current work, “74% of studies evaluated in a systematic review found a partially or consistently negative association between physician age and adherence to recommended treatment”.
The authors suggest there may be a need for continuing education throughout doctors’ working lives.
The results of this type of review, they add, are “providing much needed evidence to inform clinical practice, educational innovation, organisational redesign, and healthcare policy.”