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Your doctor’s age may be lethal

Doctors are among a unique group of professionals who work till they get to a ripe age. It’s not unusual to find doctors in their 7th or 8th decades still running busy clinical practices. But questions often arise about the quality of medical care provided by increasingly older doctors.

The question about advancing age and continued medical practice is not new. But a newly published study has again brought the matter into the spotlight. This study looked at patient outcomes following admissions and treatment in US hospitals. Among the items under observations were mortality (or death) rates, readmission rates, and costs. Key findings indicated that patients treated by older physicians had higher mortality rates, with the exception of older physicians who had high volumes of patients. The costs of care were also slightly higher with older physicians.

But how old is old? In this study, physicians aged 40 and below had the lowest mortality rates, while those aged 60 years and above had the highest mortality rates. But why is this the case? You would intuitively think that older physicians have more experience, and you would naturally expect them to have better outcomes. But this expectation was not supported by the study observations.

Well, the supposition is that older physicians might have decreasing clinical knowledge compared to their younger counterparts. The older ones may also still lean on outdated skills, and not be readily up to date with newer models of care, and novel medical technologies. Still the more aged physicians may not subscribe to current clinical guidelines, and may perform worse on quality processes that intertwine diagnoses, screening and preventive care.

It appears the better metrics with younger physicians are linked to more recent training. But other metrics may favor the older physicians, like communication with patients and more restrained invasive interventions.

Should these study findings suddenly prompt you to review the age of the doctors you currently see? Well, there are many facets to overall quality of medical care. The individual doctor matters. But more importantly, the culture of quality and safety in the institution you get your care from matters much more. Other notable studies have shown that healthcare institutions, with sound quality processes in place, create desirable patient outcomes regardless of variation in the clinical performance of individuals.

There are other safeguards in place to keep you safe regardless of your doctor’s age. Maintenance of medical licensing legally mandates doctors to keep themselves up to date with changing medical practices. The advent of team-work, with shared skills within medical specialists, keeps you within the confines of optimal care. But you must also play an individual role in selecting your physicians. The oldest is not necessarily the most skilled, or experienced. The youngest may be the most medically tech savvy, but they may not necessarily make the most objective clinical decisions.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke

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