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Systematic Review: Association Between Physicians' Clinical Experience and Quality of Care and Patient Outcomes
Mitsuhiro Shimada1, Toshiki Kuno2, Yu Shindo3
1Department of Hematology, Medical Research Institute Kitano Hospital, Osaka, Japan.
Background:
Physicians with longer clinical experience may accumulate, or conversely exhibit obsolescence of, clinical knowledge and skills.
Objective:
This systematic review aims to summarize current evidence of the impact of physician experience on quality of care and patient outcomes.
Methods:
We conducted a systematic review by searching EMBASE and MEDLINE databases from 2005 to 2025. Studies were included if they evaluated an association between physician experience-either length of practice or age-and quality of care and patient outcomes (i.e., knowledge, adherence to standard of care, and clinical outcome).
Results:
We included 69 studies. Overall, 32 (46%) of 69 studies showed that physicians' experience or age has a negative impact on the quality of care and patient outcomes, whereas 16 (23%) studies reported a positive impact of experience or age. The negative impact of physician experience was observed in the knowledge and adherence to the standard of care domains: 12 (52%) of 23 studies in the knowledge domain and 14 (61%) of 23 studies in the adherence domain showed a negative effect of experience or age. We found mixed findings for clinical outcomes; six (26%) of 23 studies reported negative and nine (39%) reported positive associations. These relationships were consistent when we limited the studies with low or moderate risk of bias as well as moderate or low certainty of evidence.
Conclusions:
The older age and increased experience of physicians were associated with inferior knowledge and less adherence but not correlated with clinical outcomes.
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