Our least favorite type of research is the observational study. Think: eggs are good for you, eggs are bad for you; eat meat, don’t eat meat; statins cure everything, statins cause everything; and on and on.
However, observational studies can be a first step into deeper understanding. An example is Jenner’s observation that milkmaids who contracted cowpox did not get smallpox. In the current "publish or perish" environment, the necessary deeper inquiry (Jenner tested vaccination, albeit in a crude way as we look back) often does not happen. Public media grabs and grasps the story, disseminates the story, and the story disappears and is gone within less than 24 hours. Another publication is notched for institution and researcher. Big data is thanked. Rarely do we find someone who goes on to ask why.
Certainly, inquiry into what works and what doesn't is extremely valuable. That said, two recent studies also beg for a deeper answer. Both are by the same author. The first study by lead author Yusuke Tsugawa observes the female physicians have fewer patients die or be readmitted. They speak of adherence to clinical guidelines and “patient centered communication."
The second study concludes that younger physicians have fewer patients die while the readmission rate is the same. It pits older physicians against younger physicians. Medicare patients formed the sample. Policy implications concluded that medical education and its maintenance of certification is important.
There is no doubt that the younger physician is a better coder and understands the value of coding maybe even over outcome. Could this be the education that is required?
But, let’s not quibble over reasons and explanations. Above all, what matters most is how we can improve medicine.
Assume the conclusions are correct, and that there are indeed differences born of gender and age. Why not encourage, support, and demand collaboration and communication? Bring the old to share with the young, the young to teach the old. The style of the female to mesh with the style of the male.
Regardless of whether these studies are strong and solid and show true causality between these physician demographics and their outcomes... Why not work together, rather than focus on controlling the parts?
These stories of medical collaboration show that you can take outcomes into your own hands: