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Who Is A Better Physician: Younger & Sharper, Or Older & Experienced?

By Dr. Dave Hnida

DENVER (CBS4) -It's actually a question has been around for quite some time.  Is it better to have a younger physician who perhaps is a little sharper and perhaps is a little more up-to-date on the latest information and technology… or is it better to go with older and maybe a little more experienced in the ways of the world when it comes to your health.

It's a question that certainly has been intriguing to me because I have had the opportunity to be both: A young hotshot physician thinks he knows everything in the world, and now an older, more experienced doctor who wonders how the heck someone younger to me could possibly think they know more than I do.

So now comes this new study in the British Medical Journal which attempts to answer this deep, pondering question.  In the results are not necessarily so good for the older generation of physicians like myself.

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Surgery (courtesy Dr Dave Hnida)

The study followed more than 786,000 patients over a 3-year period, took a look at their hospitalizations, and also the time frame for 30 days after their hospitalization.  All of the patients were over age 65.  It then attempted to analyze just how well these patients did in terms of their recovery and need for re-hospitalization because of complications or other issues after the first go round.

The headline of the study is pretty blunt. It basically says that younger is better when it comes to outcomes, meaning, that the chances of you recovering is higher if you have a younger physician taking care of you.

It kind of bummed me out to read that. But then I took a look at the details of the study, and like with all studies the details certainly are important.

Generic Surgery, Operation, Emergency Room
(credit: CBS)

First off the study did not look at regular every day medical care like you would get in a doctor's office. It only looked at the patients were cared for by what are known as hospitalists. Hospitalists are physicians who only take care of hospitalized patients. It did not include ER doctors or surgeons. Hospitalists do not do any care before patient is admitted or after the patient is discharged.

Secondly, the numbers really weren't that spectacularly different.

For example, for hospitalists under age 40 the rate of problems was 10.8 percent.

For hospitalists each wean the ages of 40 and 49 the rate of problems was 11.1 percent.

For hospitalists between the ages of 50 and 59 the rate of problems was 11.3 percent.

These are hardly earth shattering differences in mini- percentages, but yet the study sounds like if you have an older physician take care of you, you are in big trouble. And that does not even take into account that when the study took a look at older physicians who were very busy, their complication rate actually was less than younger physicians, yet this fact is buried in the middle of the study.

I think the bottom line here is that the study really does not answer the question of who is really better: Younger or older. In fact from personal experience I think it's safe to say that this all is really is a matter that is most satisfactorily answered on an individual basis. It's possible have someone who is young and dumb but then again it's also possible that have someone who is old and dumb… and vice versa in terms of intelligence, clinical skills, and a higher odds of you surviving hospital stay. I personally know some young docs fresh out of residency and fellowship that I certainly would like take care of me, and in many ways would prefer to have them take care of me. But this is not an across-the-board feeling. Age alone does not define quality.

The bottom line really seems to be how well do we physicians as a group, no matter what are age, stay up-to-date on the latest technologies as well as being aware of the latest clinical quality guidelines for care.  Medicine is like weather in Colorado--- rapidly and ever-changing.  And if you don't keep up with things you are really performing a disservice to your patients.

Dr. Dave Hnida is CBS4's Medical Editor. He blogs about the latest studies and trends in the health world. Read his latest blog entries, check out his bio or follow him on Twitter @drdavehnida

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