4 ms·

In Canada, subjectively, it feels like the quality of newer doctors has gone up dramatically. The training must be a lot better these days. I’ve been impressed,

In Canada, subjectively, it feels like the quality of newer doctors has gone up dramatically. The training must be a lot better these days. I’ve been impressed, especially when you go in to a clinic where they actively take in students for their practicums - the old doctors are often stepping up their game as well

mlinhares 2y ago
There’s considerable research on the subject: https://www.mdlinx.com/article/are-older-doctors-wiser-not-necessarily/01FmC1yV5CNRDrQpaQpy6R https://www.mdlinx.com/article/are-older-doctors-wiser-not-n...
- sampo 2y ago
  > https://www.mdlinx.com/article/are-older-doctors-wiser-not-necessarily/01FmC1yV5CNRDrQpaQpy6R https://www.mdlinx.com/article/are-older-doctors-wiser-not-n... Link doesn't work in Europe, redirects to https://eu.m3.com/ https://eu.m3.com/.
  - mlinhares 2y ago
    This freakonomics episode covers some of the research as well: https://freakonomics.com/podcast/how-can-you-choose-the-best-doctor/ https://freakonomics.com/podcast/how-can-you-choose-the-best... From the transcript: > But before you go looking for the oldest doctor you can find, you know, hold on for a second. Turns out that what David and his colleagues found in obstetrics may not apply to all fields of medicine. Let me give you an example. A few years ago, we looked at a similar question among internists who provide care to hospitalized patients. These doctors are called hospitalists and nowadays if you’re hospitalized with a general medical condition like pneumonia or heart failure, chances are you’ll be treated by one of these types of doctors. So, my colleagues and I looked at whether the age of a hospitalist physician was tied to outcomes among elderly patients. We looked at about 730,000 hospital admissions by nearly 19,000 physicians and we found that patients treated by older physicians had a higher rate of mortality within a month of their admission date — it’s called “30-day mortality” — compared to patients treated by younger physicians. More patients died under the watch of doctors who were age 60 or older. And interestingly, doctors who were just five years out from their training lost the fewest patients. That finding appears to contradict David’s data showing that obstetricians continued to improve even 30 years into their career.
  - tim333 2y ago
    There's an archive version https://archive.ph/fpyEG https://archive.ph/fpyEG
flakeoil 2y ago
It should be quite naturally so as a lot has happened in the field of medicine in the last 30-40 years. A 60 year old doctor who was trained 35 years ago uses old knowledge and techniques. Even though doctors get some updates via conferences and articles in journals and maybe some hand on course, they cannot absorb all that new knowledge in practice.
- throwaway8877 2y ago
  Perhaps. But they have advantage of 30-40 years of experience.
  - Kalium 2y ago
    It's my understanding that the significance of that age can and does vary wildly. In some specialties, age makes errors more likely: https://psnet.ahrq.gov/issue/radiologist-age-and-diagnostic-errors https://psnet.ahrq.gov/issue/radiologist-age-and-diagnostic-...
  - prmph 2y ago
    But here's the things I'm not clear about: Surgeon get immediate feedback if they make mistakes because their patient might die or get severely disabled, but is there any feedback to GPs about the effectiveness of their work? Let's say someone is not treated that well by his doctor for a chronic condition. He gets to the emergency in a different hospital and probably dies. Does his GP get to know about it? For example, many doctors in my country believe that Left Ventricular Hypertrophy (LVH) on an ECG is nothing much to worry about, as long as there is no anatomical LVH showing up on an Echocardiogram. Yet, study after study online concludes that ECG LVH is a serious marker of cardiac pathology distinct from (but related to) from anatomical LVH. How do doctors who operate on this assumption going to learn from experience, if they mostly don't know that their patients have cardiac events as a result?
    - xyzzy123 2y ago
      Surgeons don't get immediate feedback because the advisability of procedure X ends up being a statistical matter that might not be decided in the surgeon's lifetime. It depends what it is. They will have opinions of course, but will work with the system and follow process.
sn9 2y ago
At least in the US, the widespread use of Anki by medical students has actually impacted the way standardized testing are written/graded IIRC.
- doesnotexist 2y ago
  Wow, it's amazing to me how much anki eventually caught on with medical students. Back in 2008 I introduced my med school classmates to Anki via a web app front end that I scrapped together. Basically it allowed us to crowdsource a shared flashcard corpus but with individual accounts each with their own state for Anki's SRS, allowing us to practice from any web browser without having to have Anki installed locally. Though it had some success among some of my fellow students, the vast majority of the class did not want to engage with a web app for studying back then, so I'm surprised by how much penetration it has now.

mlinhares 2y ago

There’s considerable research on the subject: https://www.mdlinx.com/article/are-older-doctors-wiser-not-necessarily/01FmC1yV5CNRDrQpaQpy6R https://www.mdlinx.com/article/are-older-doctors-wiser-not-n...

sampo 2y ago
> https://www.mdlinx.com/article/are-older-doctors-wiser-not-necessarily/01FmC1yV5CNRDrQpaQpy6R https://www.mdlinx.com/article/are-older-doctors-wiser-not-n... Link doesn't work in Europe, redirects to https://eu.m3.com/ https://eu.m3.com/.
- mlinhares 2y ago
  This freakonomics episode covers some of the research as well: https://freakonomics.com/podcast/how-can-you-choose-the-best-doctor/ https://freakonomics.com/podcast/how-can-you-choose-the-best... From the transcript: > But before you go looking for the oldest doctor you can find, you know, hold on for a second. Turns out that what David and his colleagues found in obstetrics may not apply to all fields of medicine. Let me give you an example. A few years ago, we looked at a similar question among internists who provide care to hospitalized patients. These doctors are called hospitalists and nowadays if you’re hospitalized with a general medical condition like pneumonia or heart failure, chances are you’ll be treated by one of these types of doctors. So, my colleagues and I looked at whether the age of a hospitalist physician was tied to outcomes among elderly patients. We looked at about 730,000 hospital admissions by nearly 19,000 physicians and we found that patients treated by older physicians had a higher rate of mortality within a month of their admission date — it’s called “30-day mortality” — compared to patients treated by younger physicians. More patients died under the watch of doctors who were age 60 or older. And interestingly, doctors who were just five years out from their training lost the fewest patients. That finding appears to contradict David’s data showing that obstetricians continued to improve even 30 years into their career.
- tim333 2y ago
  There's an archive version https://archive.ph/fpyEG https://archive.ph/fpyEG

flakeoil 2y ago

It should be quite naturally so as a lot has happened in the field of medicine in the last 30-40 years. A 60 year old doctor who was trained 35 years ago uses old knowledge and techniques. Even though doctors get some updates via conferences and articles in journals and maybe some hand on course, they cannot absorb all that new knowledge in practice.

throwaway8877 2y ago
Perhaps. But they have advantage of 30-40 years of experience.
- Kalium 2y ago
  It's my understanding that the significance of that age can and does vary wildly. In some specialties, age makes errors more likely: https://psnet.ahrq.gov/issue/radiologist-age-and-diagnostic-errors https://psnet.ahrq.gov/issue/radiologist-age-and-diagnostic-...
- prmph 2y ago
  But here's the things I'm not clear about: Surgeon get immediate feedback if they make mistakes because their patient might die or get severely disabled, but is there any feedback to GPs about the effectiveness of their work? Let's say someone is not treated that well by his doctor for a chronic condition. He gets to the emergency in a different hospital and probably dies. Does his GP get to know about it? For example, many doctors in my country believe that Left Ventricular Hypertrophy (LVH) on an ECG is nothing much to worry about, as long as there is no anatomical LVH showing up on an Echocardiogram. Yet, study after study online concludes that ECG LVH is a serious marker of cardiac pathology distinct from (but related to) from anatomical LVH. How do doctors who operate on this assumption going to learn from experience, if they mostly don't know that their patients have cardiac events as a result?
  - xyzzy123 2y ago
    Surgeons don't get immediate feedback because the advisability of procedure X ends up being a statistical matter that might not be decided in the surgeon's lifetime. It depends what it is. They will have opinions of course, but will work with the system and follow process.

sn9 2y ago

At least in the US, the widespread use of Anki by medical students has actually impacted the way standardized testing are written/graded IIRC.

doesnotexist 2y ago
Wow, it's amazing to me how much anki eventually caught on with medical students. Back in 2008 I introduced my med school classmates to Anki via a web app front end that I scrapped together. Basically it allowed us to crowdsource a shared flashcard corpus but with individual accounts each with their own state for Anki's SRS, allowing us to practice from any web browser without having to have Anki installed locally. Though it had some success among some of my fellow students, the vast majority of the class did not want to engage with a web app for studying back then, so I'm surprised by how much penetration it has now.