More experienced physicians provide poorer quality medical care?

A study conducted by Harvard Medical School researchers suggests that physicians' knowledge and performance decreases as their years in practice increase. The study, based on a review of 62 evaluations within 59 articles, found that 52% of the evaluations showed a negative association between experience and performance-that is, increasing experience was associated with a decline in performance. Only one evaluation showed a positive association.

Based on their analysis, the researchers concluded that older physicians, or those with more years of experience, "possess less factual knowledge, are less likely to adhere to appropriate standards of care, and may have poorer patient outcomes." To explain their findings, the researchers point to the possibility that physicians are not getting regularly updated training, as well as a shift in the profession's environment from relying on personal experience in making medical decisions to evidence-based medicine.

The researchers say their results "are troubling" and suggest that older physicians may need quality improvement intervention that can be applied to all of those in the profession. In addition, they recommend further evaluation of continuing medical education requirements, as well as the need to expand recertification for all physicians, regardless of age.