Older and Wiser? Years in Practice and Obstetric Outcomes

The growing emphasis on measuring and improving quality of obstetric care focuses increasingly on outcomes attributable to individual clinicians. How does likelihood of adverse outcomes change over the course of an obstetric career? To explore the relation between physician experience and performance, investigators assessed rates of maternal adverse outcomes (infection, hemorrhage, thromboses, major operative complications, and severe lacerations) by provider as a function of year since completion of obstetric training.

Of 6.7 million deliveries performed from 1992 through 2010 by 5175 obstetricians, risk for a delivery complication was 15% during the first year after residency (14% for cesarean deliveries, 16% for vaginal deliveries) and fe…