We generally think of experience as being a good thing. But what about in medicine, where our knowledge base is expanding almost daily and more often than not, things we used to do are discovered by further research to be more harmful than good. Or, at the least, not beneficial.
So, maybe what’s important is not how much experience a physician has, but rather how diligently they keep up to date with the latest research on medicine and apply this to the wealth of experience. Given the massive marketing push that accompanies the launch of new drugs, it would be hard for any physician to miss. But what about the less-publicized black box warnings or frank withdrawal of these same blockbuster drugs? So, while this may seem like a self -serving attempt to make my patients appreciate me more, but let me give a few examples.
While this particular study finds that patients of doctors with more experience have a higher risk of in-hospital and 30-day mortality, which is disturbing in and of itself, let’s look at some closer to home examples.
The entire class of selective COX-2 inhibiting anti-inflammatories was launched with massive fanfare and quickly became one of the best selling drug classes of all time. It was several years before the whistleblowers were able to get the information on the cardiovascular toxicity to the FDA and ultimately Vioxx was pulled off the market. But the other drugs in this class were never pulled off the market. Fast forward years later and this class of drugs is still in use, despite research finding that the risk of causing ulcers (the entire reason this class of drugs was developed in the first place) was only minimally impacted. A physician unaware of the breadth of research on this class of drugs may still be mistakenly using this class of drugs, increasing the risk of heart attacks or strokes in their patients.
Beta blockers used for blood pressure are well documented to increase the risk of both diabetes and strokes. The risks clearly outweigh the benefits when other classes of drugs have been shown to be as effective without the risk of diabetes and stroke. A physician unaware of this research may continue to use beta blockers in his or her patients because it’s what they’ve always done. Their patients are at increased risk of harm as a result.
So, when looking for a new physician regardless of reason or specialty, maybe the most important question should not about experience, but rather…”what do you read to stay current?: