The independent effect of age of general practitioner on clinical practice

Objective: To establish the extent to which general practitioner age alone explains variations in patient morbidity and treatment patterns. Setting: An on-going, national survey of general practice activity in Australia. Participants: A random sample of 5013 GPs with a minimum of 375 general practice Medicare items claimed in the previous 3 months. Each GP contributed details of 100 consecutive encounters, with about 1000 GPs sampled each year between 1998 and 2003. Main outcome measures: Effect of practitioner age on GP activity after removing the influence of measured confounding factors: doctor, patient and practice characteristics; number of problems; and morbidity managed at encounters. Results: GP age played a significant role in practice style. In comparison with young GPs (< 35 years), older GPs provided more home visits (P< 0.001) and attendances at residential aged-care facilities (P= 0.044); were more likely to manage chronic problems (P< 0.001); had higher prescribing rates (P< 0.001), and lower rates of pathology ordering (P< 0.001) and non-pharmacological treatments (P< 0.001). Individual body System management rates also differed significantly between younger and older GPs. Conclusion: A GPs age plays a significant role in determining practice style. Our results have implications in terms of the ageing GP population and in the wider context of the ageing medical labour force.