Physician Age and Patient Outcomes: A Systematic Review

Background: An aging population, with rising healthcare needs, places a high strain on the medical workforce. How the aging of healthcare providers affects patient outcomes has garnered considerable interest; however, comprehensive data synthesis is lacking. Therefore, we sought to assess associations between physician age and outcomes of adults receiving medical or surgical care. Methods: This systematic review was prospectively registered on PROSPERO (CRD42024503166). MEDLINE and EMBASE were searched to January 16th, 2024, and supplemented by a hand search. Eligible studies included randomized controlled trials or observational studies enrolling adults (≥ 18 years) that examined associations between surgeon or medical physician age and patient outcomes (i.e., mortality, hospital readmission, complications, length of stay). Given the heterogeneity of data, a meta-analysis was not conducted. Results: Across 17 observational studies (n = 7,311,162), 14 (n = 3,944,944) assessed surgeon age while 3 (n = 3,366,218) examined physician age in medical care. Ten studies were rated as having moderate, six having severe, and one having a critical risk of bias. The threshold for older surgeon age varied from ≥ 45 to ≥ 65 years across surgical studies, while those focusing on medical care utilized a cut-off of ≥ 50 to ≥ 60 years of age. Older surgeon age was generally associated with lower patient mortality; however, there were inconsistent and often insignificant differences in operative mortality. Younger surgeon age was associated with higher complication rates in some studies, with mixed findings on readmission rates and no clear association with hospital length of stay. There was limited data on people receiving medical care, but those treated by younger physicians showed evidence of lower mortality. Discussion: Findings were mixed for both medical and surgical care, with interpretation limited by variable age cut-off definitions, heterogeneous data reporting, and a disproportionate focus on surgical care. Given the aging workforce, further research is needed to support dialogue and policies on medical workforce planning.