Age matters: The older the physician, the fewer the patient complaints

It turns out the age of a physician does influence the likelihood patients will have a complaint.

However, the older the doctor, the fewer patient complaints, according to a study published in JAMA Ophthalmology.

Researchers from Vanderbilt University School of Medicine in Nashville, Tennessee, wanted to see if physician age was associated with an increased likelihood of receiving unsolicited complaints among ophthalmologists. When they reviewed 1,342 doctors, they found that increasing physician age was associated with a decreased risk of patient complaint.

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Why late-career physicians had fewer complaints remains to be explored, the researchers said. For the study, they reviewed the rate of complaints over time by physician age using patient complaints registered between 2002 and 2015 in Vanderbilt’s Patient Advocacy Reporting System, a database of complaints and physician specialty data. The doctors were from 20 U.S. healthcare organizations that participate in the system.

The median physician age was 47, with 9% of the doctors 71 years or older. The ophthalmologists older than 70 had the lowest complaint rate and the longest mean time before receiving a patient complaint.

Over the course of the study, 564 ophthalmologists, or 42%, had at least one unsolicited patient complaint.

While it wasn’t clear why the older doctors received fewer complaints, the researchers said early-career physicians may face the challenges of mastering new clinical systems and how best to provide excellent care largely on their own. They speculated that because younger physicians may be more up-to-date with best practices, complaints may come less from cognitive or technical deficits and more from behavioral and confidence issues.

Younger doctors may also have novice support staff and nurses, a larger share of “difficult” patients referred by late- and midcareer ophthalmologists and insufficient training and experience to handle unsolvable medical situations or emotionally difficult conversations, the researchers said.

Midcareer physicians may be driven to undertake greater workloads, the researchers said. As their practices grow, they may see more patients and face complaints about shortened visits, poor availability and lower quality of care, the researchers said.

In older physicians, a rapid increase in patient complaints against a doctor who had few or none may signal a need for physical, mental and skills assessments, they said.

And while they may get fewer complaints, one study found patients treated by older doctors have higher mortality rates than those treated by younger physician.