Cogitations on Maturity and Practice Expertise

Abstract

This systematic review included 62 studies intended to measure physician knowledge or quality of care in relation to age or time since medical school graduation. Groups ranged in size from 22 to 6344 and consisted mostly of generalists and internists, but also some specialists, including surgeons, cardiologists, gynecologists, anesthesiologists, psychiatrists, and pediatricians. Most measures were assessed by questionnaire and focused upon clinical knowledge and standards of practice for diagnosis, screening, prevention, and therapy. Only 7 studies dealt with actual health outcomes. Most studies (52%) showed “decreasing performance with increasing years in practice.” The ages of the authors (a potential conflict-of-interest source) are not cited. Thus far, the failing competence of maturing neurologists has escaped notorious documentation. Grow old along with me! The best is yet to be, The last of life, for which the first was made. Our times are in His hand. Robert Browning Evidently, editor Samuels dumped (assigned) this review upon me because I have no conflict of interest, since my aged but now-yellowing American Board of Psychiatry and Neurology (ABPN) Neurology Board Certificate is secure from medicolegal recertification challenge. Certainly, it cannot be gainsaid that all neurologists’ performance is a fair issue of concern, both …