As the 2016-2017 academic year enters is last few weeks, the annual changes are afoot. A new year of interns are (hopefully) enjoying the end of their fourth year before the exciting journey of residency begins, current house staff prepare for new responsibilities and the perennial question of how well this whole system works for patients is asked anew.
Overall, recent answers seem encouraging. The May 23/30 JAMA includes a comparison of teaching and non-teaching hospitals. This review of millions of hospitalizations at thousands of US hospitals for patients suffering from many common conditions shows a small but consistent reduction in 30 day mortality for teaching hospitals compared with non-teaching hospitals.
Similarly, the BMJ recently published a study comparing outcomes for elderly patients depending on their physician’s age. Though published in BMJ, like the JAMA article it is a study of Medicare beneficiaries. It also showed a small but consistent reduction in 30 day mortality for younger physicians and what’s more, the younger cohort also delivered lower cost care. But one main caveat before our youngest physicians let out the ticker tape: if the older physicians had high clinical volumes (>201 admissions per year), the difference completely disappears.
So to our hardworking residents and faculty nationwide, thank you for your dedicated work – it seems to be paying off not just in the future but today and everyday in our busy teaching hospitals.