Most of us who have been in practice for a while would probably prefer to think that our accumulated experience must be of some benefit to our patients. Personally, I prefer a bit of experience in some professions… airline pilots for example (I just feel better when I see a gray haired, “Captain Sully” type in the cockpit!). But as you’ll see, experience may not always be the best teacher when it comes to the practice of medicine. This month’s column recaps our review of a 2011 article which sought to determine how physician experience might impact patient outcomes within a hospital setting. And while we don’t have a comparable study that applies specifically to chiropractic, this study should provide food for thought, especially for those of us who have been in practice for a while. Thanks to our chiropractic sciences contributor Roger Coleman, DC (Othello, WA) for this interesting article. I hope you find it helpful.
The Study: Longer lengths of stay and higher risk of mortality among inpatients of physicians with more years in practice
- It has been reported that physicians who have more years in practice do not adhere as closely to established practice guidelines.
- The authors sought to determine if the number of years a physician had practiced was associated with any differences in patient outcomes.
- They looked at 59 physicians and 6,572 patient admissions.
- Physicians were divided into 4 groups.
- The groups were composed of physicians who had practiced 0-5, 6-10, 11-20 and over 20 years.
- Patients who were treated by each group of physicians tended to be rather similar.
- The length of hospital stay for patients was shortest for physicians with 0-5 years of practice experience at 4.77 days. The 6-10 years of practice physician group averaged 5.29 days of patient stay. Doctors with 11-20 years of practice averaged 5.42 days of patient stay while those with over 20 years of practice averaged slightly less at 5.31 days of patient stay.
- However, both “in hospital” mortality and the mortality within 30 days of discharge was highest among patients treated by physicians having 20+ years of practice experience.
Years of practice time may not equate to better outcomes. Regardless of experience, everyone needs to adhere to best standards of practice.
…encouragement for providers, such as yourself, who are making the effort to stay up to date with the scientific literature.
I was surprised because I thought more experience would result in better outcomes. This may come as a wakeup call to keep providers on their toes and motivate them to stay up-to-date throughout their career. This would also seem to be an encouragement for providers, such as yourself, who are making the effort to stay up-to-date with the scientific literature.
Roger Coleman, DC
Southern WN, Bellin EY, Arnsten JH. Longer lengths of stay and higher risk of mortality among inpatients of physicians with more years in practice. Am J Med. 2011 Sep;124(9):868-74.
Link to Abstract:
Dr. Mark R Payne, Phenix City, AL is Editor of ScienceInBrief.com, a scientific literature review for busy chiropractors. He is also President of Matlin Mfg Inc. a manufacturer of postural rehabilitation products since 1988. Subscription to ScienceInBrief.com is FREE to doctors of chiropractic and chiropractic students. Reviews of relevant scientific articles are emailed weekly to subscribers.