Are you suggesting cognitive testing throughout a physician’s career?
Yes – I think that there should be cognitive testing throughout a physician’s career; and for those who work with their hands, such as surgeons, there should be simulator manual tests, which work well in the airline industry.
Unfortunately, in the airline industry, all that good testing hasn’t negated mandatory chronological retirement age. There are also mandatory retirement ages in other industries, including among FBI agents and park rangers; but in medicine, a mandatory retirement age wouldn’t be in the best interest of either the public or the medical profession. Instead, competence should be assessed regularly and age stereotypes should be resisted. There are people who can practice medicine and perform operations well at age 80 and people who shouldn’t be practicing at age 50. The biological age and individual skills are what’s important, not the chronological age.
What are some of the drawbacks to the current approaches of hospital systems?
The quality assurance procedures of hospitals will not address this issue. When problematic outcomes arise in a given physician, they are hopefully identified early; and in a responsible administration, physician leadership usually intervenes. The reason this is not a good system is that it means that bad outcomes already have occurred. If a physician has been sued several times in the last year, we know there’s a problem, and we should have the mechanism to become aware of that as a potential problem before the first lawsuit.
Peer observation and information from nurses could provide insight that could be implemented immediately if age issues were included among the general physician wellness issues that hospitals are now required to address.
What other thoughts do you have about aging physicians?
As a profession, we are tasked to find ways to get answers not only about older physicians’ competence, but also about how to help physicians transition their practices so that they can continue to work safely for longer periods of time. Hospitals are now paying attention to resident wellness and trying to decrease physician suicide rates, but not to aging or the aging transition, which is important not only to doctors but also to health systems. There should be educational and transitional programs that make it easier for doctors to recognize when they are developing decreased abilities and transition in a productive way to activities that they can do well. Then they can continue to contribute to society and the medical profession for long periods of time without the stigma currently attached, which is waiting for people to make mistakes and then telling them that they can’t work anymore.
It is essential for the medical community to define competency and develop valid assessment tools quickly before someone else (such as the government) does.
Establishing transition flexibility, altering workloads, minimizing work barrier, educating physicians about finance – which many don’t know anything about – and creating post-clinical retirement opportunities could all be done immediately and be very helpful.
This article originally appeared on MPR