by Angela Sams

If you need some sort of serious medical procedure done or find yourself in the hospital for another reason, you would probably want the best, most experienced doctor, right? To the contrary, a recent New York Times op-ed article by Dr. Ezekiel Emanuel indicates that the opposite may be true. The article explores a recent research paper published in JAMA Internal Medicine, which analyzed ten years of data regarding hospital admissions. The research shows “that patients with acute, life-threatening cardiac conditions did better when the senior cardiologists were out of town.” This was the case at what are considered “the best hospitals in the United States, our academic teaching hospitals.” When the top senior cardiologists were absent, patients’ mortality was decreased by approximately one third. Furthermore, patients whose heart conditions are treated in a teaching hospital rather than a community hospital generally fare much better.

One would think that an older, more experienced doctor would be more adept at treating patients, but Dr. Ezekiel poses the idea that younger doctors are still fresh from training and may be better at clinical treatment, whereas older doctors are better at the research side of medicine. Senior doctors may also be more likely to try more interventions. The data in this recent paper, along with other recent studies, seem to indicate that less is better in terms of healthcare. It’s important to remember that with each new test or treatment comes the potential for side effects or something going wrong.

Perhaps doctors should be required to give patients information about a potential procedure and prevent over-medication by attempting to discontinue medications annually. Dr. Ezekiel suggests that patients can also become involved in their own care by asking four simple questions before a procedure:

• What difference will it make, and will the test results change the treatment approach?

• How much will this treatment improve the prolongation of my life and reduce the problem?

• How likely and severe are the side effects?

• Is this a teaching hospital?

Patients have a right to be as involved as possible in their care. And, while it may make a doctor uncomfortable to be asked such questions, if they truly have the best interest of the patient at heart, they will be more than happy to answer.