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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Is an Older, More Experienced Doctor a Better Doctor?
15 February 2005 | Volume 142 Issue 4 | Page I-54
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full report titled "Systematic Review: The Relationship between Clinical Experience and Quality of Health Care." It is in the 15 February 2005 issue of Annals of Internal Medicine (volume 142, pages 260-273). The authors are N.K. Choudhry, R.H. Fletcher, and S.B. Soumerai.
What is the problem and what is known about it so far?
Quality health care is sometimes defined as care that delivers the best possible results by using the right decisions made at the right time in the right way for the right patients. Making the right decisions requires familiarity with the latest medical knowledge and use of good clinical judgment. It is not known whether experience in practice influences this knowledge and judgment. Younger doctors may be more knowledgeable about the latest medical advances but may have less developed clinical judgment because of their relative lack of experience. Conversely, older doctors who have practiced medicine for many years may have more developed clinical judgment but may know less about the latest advances in medicine. It is also not known whether these factors affect patient outcomes.
Why did the authors do this review?
To determine whether experience in practice is associated with the quality of health care delivered by doctors. The authors reviewed research that used different measures of experience and different measures of health care quality and pooled the results.
How did the authors do this review?
They searched MEDLINE, a large online collection of scientific articles, and identified research articles published between 1966 and 2004 that studied the association between experience in practice and health care quality.
What did the authors find?
59 studies that addressed the association between experience and health care quality. Most studies found that health care quality decreased as doctor experience or age increased. Doctors who were older or who had been in practice longer seemed to be less current with recent medical advances and also followed standards of care less closely. Several studies also suggested that patients of older doctors experienced worse outcomes.
What are the implications of the review?
Existing research suggests that doctors who are older or who have been in practice longer may provide lower-quality health care. However, these findings do not apply to all older doctors and must be confirmed by more specific research. This review should provoke careful study of the relationship of physician experience and the quality of care.
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