Systematic Review: Association Between Physicians' Clinical Experience and Quality of Care and Patient Outcomes

Abstract

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.