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Patients worse off with more-experienced docs?

Jul 15, 2011, 1:35 p.m.

"It's not quite as simple to say that as you get further away from training, your quality gets worse," cautioned Choudhry.

The problem, he said, is not with the capability of the more experienced doctors, but rather, their familiarity with more current guidelines and practices. The results suggest the need to rethink the way doctors are continually educated in the years after completing their certification, he added.

The authors suggest that physicians with more than 20 years in practice be required to recertify periodically. Most of the older doctors in the current study are presently exempt from having to take recertification tests, they say.

Most doctors do participate in "continuing medical education" programs after they finish their training. But much of it is passive, consisting mostly of attending lectures and reading articles by medical researchers. While these are important ways of learning new findings, said Choudhry, it would be better to develop educational programs that would actively engage the more experienced physicians.

Dr. Steven Weinberger, executive vice president and CEO of the American College of Physicians, cautioned that it is premature to make drastic changes based on the results of the study, which only looked at small numbers of attending physicians. He also came up with several alternative explanations for the findings.

For instance, the fact that patients were in a teaching hospital might have contributed to the different rates of death, since more experienced doctors might give the doctors-in-training more autonomy. And the different lengths of time patients stayed in the hospital could reflect a cultural difference in today's younger physicians, who are taught to focus on reducing hospital stays.

Despite his concerns about the study, Weinberger agreed, "It is important for physicians to stay as current as possible."

SOURCE: http://bit.ly/pvz5xz American Journal of Medicine, online July 11, 2011.

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