When choosing a physician, one of the factors I always consider, personally, is experience. Other things being equal, I’m most likely to choose someone with many years of practice under his or her belt. Then again, youthful energy and more modern education also have their benefits. Which to choose when? That’s what a recent study from the University of Lyon in France set out to discover. And the answer is…that more experience is often a negative, not a positive. In fact, physicians within a very particular age range appear to perform best.
To find out more, I called study coauthor Antoine Duclos, MD, PhD, an assistant professor of public health at the university.
EXPERTS PEAK IN MID-CAREER
Since they had to control the study in some way, researchers chose to study thyroid surgeons, in particular, because they had the opportunity to study this type of doctor in depth.
The study: Dr. Duclos and his team analyzed data from 3,574 thyroid removals by 28 surgeons at five academic hospitals over a two-year period. Surgeons’ ages ranged from 30 to 69. To assess the doctors’ skill levels, the researchers measured the rates at which each doctor’s patients experienced two major potential complications of thyroid surgery six months after each procedure—recurrent laryngeal nerve palsy (which brings severe hoarseness) and hypoparathyroidism (damage to parathyroid glands that leads to low calcium and cramping and muscle spasms in body parts such as the larynx, hands and feet).
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Of course, some of the patients were in worse condition than other patients before surgery and therefore more challenging for the surgeons. So the researchers did their best to adjust the study’s results for factors such as patient age, weight and overall complexity of the case. Dr. Duclos and his colleagues discovered…
- Surgeons between the ages of 35 and 50 (with five to 20 years of experience since completing their surgical residencies) were not associated with an increased rate of either complication.
- Surgeons with fewer than five years of experience were associated with an increased rate of hypoparathyroidism.
- Surgeons with more than 20 years of experience were associated with an increased rate of both hypoparathyroidism and recurrent laryngeal nerve palsy, making them the riskiest choice.
WHY MIDDLE-AGED DOCS PERFORMED BEST
Dr. Duclos isn’t sure exactly why mid-career surgeons came out on top in this study, but he did offer some theories. He told me that among young surgeons, as you would expect, there is likely a learning curve, which would explain why their complication rates were higher. As to why the most experienced surgeons did relatively poorly, the answers are a lot murkier, said Dr. Duclos. It could be that the further a surgeon gets from completing his or her surgical residency, the less familiar he or she tends to be with the latest, state-of-the-art technical skills. Or rather than outdated technique, it could be that the oldest surgeons are weary—physically and/or mentally—after performing the same procedure again and again, year after year. Weariness does not promote excellence, and as the study authors noted, talent and experience cannot compensate for a lapse in motivation or the willingness to commit to ongoing training.
CHOOSE YOUR SURGEON WISELY
If you’d like to find out how many years of experience a surgeon (or any type of MD) has, you can simply ask the doctor to tell you and to describe his background. Or you can look him up on a site such as Vitals.com, which aggregates data from federal sources, state boards of medicine, hospital sites, association sites and more. The way doctors are rated and reviewed on these sites is subjective and not necessarily reliable, but you are able to find out objective information, such as how many years of experience the doctor has, as well as other important details, including where the doctor went to medical school and whether or not he or she is board-certified.
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Keep in mind (as even Dr. Duclos mentioned) that the new study in no way suggests that every surgeon who has practiced for more than 20 years is no longer performing well or that every young surgeon with fewer than five years of experience doesn’t do an excellent job.
For me personally, one aspect of how I pick my doctors won’t change. I meet with each one face-to-face to get a feel for his or her personality and attitude. I look for intelligence, engagement, continuous learning and a sense of caring. Age may be one thing—but it’s only one thing.