Download citation file:
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.
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.
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.
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.
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.
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.
Please read the other comments before posting. Contributors must reveal any conflict
Comments are moderated and will appear on the site at the discretion of The American
College of Physicians editorial staff. Please be sure your email address is
updated in your account, otherwise the American College of Physicians will not be
able to contact you about your comment.
* = Required Field
Disclosure of Any Conflicts of Interest*
(applies to the past 5 years and foreseeable future) Indicate any potential conflicts
of interest of each author below, including specific financial interests and relationships
and affiliations relevant to the subject matter or materials discussed in the manuscript
(eg, employment/affiliation, grants or funding, consultancies, honoraria, speakers
bureau, stock ownership or options, expert testimony, royalties, donation of medical
equipment, or patents filed, received, or pending). If all authors have none, check
"No potential conflicts or relevant financial interests" in the box below. Please
also indicate any funding received in support of this work. The information will
be posted with your response.
The In the Clinic® slide sets are owned and copyrighted by the American College
of Physicians (ACP). All text, graphics, trademarks, and other intellectual property
incorporated into the slide sets remain the sole and exclusive property of the ACP.
The slide sets may be used only by the person who downloads or purchases them and
only for the purpose of presenting them during not-for-profit educational activities.
Users may incorporate the entire slide set or selected individual slides into their
own teaching presentations but may not alter the content of the slides in any way
or remove the ACP copyright notice. Users may make print copies for use as hand-outs
for the audience the user is personally addressing but may not otherwise reproduce
or distribute the slides by any means or media, including but not limited to sending
them as e-mail attachments, posting them on Internet or Intranet sites, publishing
them in meeting proceedings, or making them available for sale or distribution in
any unauthorized form, without the express written permission of the ACP. Unauthorized
use of the In the Clinic slide sets will constitute copyright infringement.
Learn more about subscription options