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Thursday, March 17, 2005

Are Older Doctors Dumber? - Reloaded

Joe Diaz and I published an e-letter about the Chourdry et al review of physicians' age versus performance. The e-letter was similar to what I had posted last month on this blog.
Coincidentally, or inspired by our letter, a whole host of other e-letters appeared, all sharply critical of the Choudry article. See all the e-letters here.
Some points that they raised were:
  • that the authors of the Choudry et al review may have had conflicts of interest that affected their results, conflicts that were not properly disclosed
  • publishing such an article, disparaging "older physicians with flimsy data," raises questions about the Annals' publishing policies at a time when older physicians are being driven out of practice early by malpractice insurance and reimbursement concerns
  • the article will be used as justification for increasing mandatory re-testing of older doctors, as was advocated by ABIM leaders in an accompanying editorial, even though it provides no evidence that such testing would actually improve performance
  • publishing the article without acknowledging its severe limitations could have grave "incalculable" effects on medicine and medical practice
Have a look.

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