Veteran vs. newer physicians - who serves you better?

I have always preferred to obtain assistance from experienced and veteran people when I need their help and service. However, based on a recent review ("Systematic Review: The Relationship between Clinical Experience and Quality of Health Care", Ann Intern Med v 142, p 260, 2005), one should question this approach! Of course, one should be very careful with such generalized assessments - many veteran physicians keep up with the most modern of developments, and some of the more junior physicians may lack experience. With this caveat in mind, let's review the study.

The researchers searched all publications between 1966 and 2004 related to this topic, and found fifty-nine articles reporting on 62 groups. Physician performance was defined as 1) knowledge, 2) adherence to standards for care and diagnosis, 3) adherence to standards of care for therapy, or 4) health outcomes (e.g., mortality). Overall, 32 of the 62 evaluations (52%) demonstrated that the veteran physicians performed less well. Only one study reported that veteran physicians perform better. The other studies resulted in various types of intermediate results.

The authors of this study emphasize that the length of time in practice may be associated with other dimensions of quality that are not evaluated in the study. Possibly, older physicians may be better at human interaction with their patients, rather than with the technical facets of their work. Indeed, some studies (but not all) show a higher level of satisfaction with veteran physicians.

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