I am guilty of it myself. When I am sick, or someone in my family, I want to see “the best” doctor, at “the best” teaching hospital. Sounds logical, right? Might not be. It turns out that getting the top doctors might not be best for your health. In fact, you might be better off when the most senior doctors are not working!
Patients do better when the senior doctors are not involved.
A study in JAMA Internal Medicine examined 10 years of data for hospital admissions for tens of thousands of patients with acute, life threatening cardiac conditions at leading teaching hospitals in the US. Surprisingly, the study found that the patients did better when the senior doctors were away at conferences.
The patients treated while the senior doctors were away had lower 30 day mortality rates, with a mortality rate decrease of approximately 30% for some patients. The study also found that patients who treated at a teaching hospital did better than those treated at a community hospital.
Why did patients fare better under the care of “junior” doctors?
In a 2015 article in The New York Times Dr. Ezekiel Emanuel proposed some possible causes: junior cardiologists who recently finished their training may be more skilled clinically, or senior cardiologists may try more interventions.
The article states that more care does not always mean better outcomes. Dr. Emanuel points out that “every test and treatment can go wrong, produce side effects or lead to additional interventions that themselves can go wrong.”
These results lead me to believe that for serious illnesses, it’s great if you can use a large teaching hospital. That being said, getting a second opinion from a junior doctor just might save your life.
What questions should patients ask before a test or surgery?
Dr. Emanuel suggests patients ask these simple questions when doctors suggest a test or surgery:
- What difference will the test or surgery make?
- Will the test result change the treatment approach?
- How much improvement can I reasonably expect?
- What are possible side effects? How likely are they? How severe could they be?
- Will the procedure be done in a teaching hospital?
For more information on how to prepare for surgery, read my posts:
- What is the Best Time of Day for Medical Care?
- Recover Faster After Surgery.
- Questions Seniors Should Ask Before Surgery.
- Questions to Ask Before Surgery.
- You Can Improve Your Surgical Outcome.
- How to Recover Faster After Surgery.
- Surgical Dangers – What You Need to Know.
To get the most out of any doctor’s appointment, read these blog posts:
- Why Take Detailed Notes at Doctor Appointments?
- 10 Tips to Communicate Better with Doctors
- How Can You Get the Best Healthcare? Actively Participate!
- Can You Trust Medical Information Online?
- Can You Trust Advice from Other Patients?
- Understanding Medical Information Is Harder Than Most Realize
- The Dangers of Too Many Tests and Treatments for Patients
Note: I updated this post on 10-22-19.