The older the physician, the more likely it is that his or her patient will die.

That's the shocking claim from a new study in the BMJ. In a nutshell, patients treated by older physicians had a higher mortality rate than patients cared for by those who were younger. Patients of physicians under the age of 40 had a 10.8 percent mortality rate, which increased to 11.1 percent for patients with doctors in their 40s, 11.3 percent for physicians in their 50s and 12.1 percent for docs 60 and older.

The BMJ researchers reviewed 736,537 admissions managed by 18,854 hospital physicians and examined Medicare patient outcomes, including 30-day mortality rate, readmissions and costs of care. Prior to this report, the issue had apparently gone largely undiscussed

According to the study, a "systematic review of the relation between physician experience and quality of care found that older physicians might perform worse — older physicians have decreased clinical knowledge, adhere less often to standards of appropriate treatment, and perform worse on process measures of quality with respect to diagnosis, screening and preventive care."

Clinical skills and knowledge can accumulate and can lead to improved quality of care with age and experience. However, according to the report, physicians' skills can become outdated as scientific knowledge, technology and clinical guidelines change.

The researchers used nationally representative data on Medicare beneficiaries admitted to hospital with a medical condition from 2011 through 2014. Data was collected from Medicare Inpatient Carrier and Medicare Beneficiary Summary Files, physician data collected by Doximity (an online professional network for physicians) and the American Hospital Association (AHA) annual survey of hospital characteristics.

Researchers then hoped to answer three questions:

  • What is the association between age of the treating physician and patient mortality after admission?
  • Did this association vary with the volume of patients a physician treats?
  • Given national efforts to improve the efficiency of healthcare, does physician age affect readmissions and costs of care?

Physician data points included age, sex, year of completion and name of medical school, residency and board certification. Patient data was selected based upon whether they were treated in acute care hospitals. The study excluded elective admissions and those in which a patient left against medical advice.

The primary outcome was the 30-day mortality rate in patients (death within 30 days of admission); secondary outcomes were 30-day readmission rates (readmission within 30 days of discharge) and costs of care.

If the information from the study is verifiable in a real-world setting, this is groundbreaking and potentially disturbing news. Imagine if such news were to become mainstream, patients concerned about their long-term health might take action by refusing care from any physician older than 40.

Or, should health system leadership grow concerned about mortality rates, they may begin to limit the age of the physicians they hire, opening a whole host of problems and legal action as well as further reducing the number of caregivers available in an already taxed system.

Not to suggest any of these scenarios might happen, but the data offered here certainly will advance those ideas, if not the conversation.