The need to identify physicians who are practicing with disabilities due to advancing age is of great importance (see: Reporting of Impaired Physicians by Their Colleagues; Dealing with the Impaired Physician). I recently came across an article indicating that some hospitals are now beginning to screen aging physicians for diminution of their physical or cognitive skills (see: More hospitals screen aging surgeons to make sure their skills are still sharp). Below is an excerpt from it:
...[D]ifficult conversations [about the competence of surgeons] have become more commonplace in recent years, because physicians...are living longer. Advances in medicine, personal wellness and public health, along with the desire to preserve a sense of purpose and their lifelong identity, have led many to work well beyond traditional retirement age. As a result, a growing number of health systems are creating policies that require clinicians of a certain age to undergo physical, cognitive and clinical testing. Those programs have been met with ire by career practitioners, who argue that age is just a number. Doctors...already must renew their medical licenses at regular intervals with state medical boards. But medical groups, patient safety leaders and others counter that the renewal process does not look for age-related cognitive and physical decline that could harm the quality of care provided to patients....The 1967 Age Discrimination in Employment Act gives the U.S. labor secretary the power to ensure that aging workers are not displaced from jobs as a result of arbitrary age limits. The law did exempt some high-risk industries. Air traffic controllers, for instance, must retire at age 56. Federal firefighters bow out at 57. Airline pilots must retire at 65. Other industries, such as accounting, also have mandatory retirement policies that are controversial and are being re-examined.
The law allows the Equal Employment Opportunity Commission to consider other reasonable exemptions. Given the high-risk nature of practicing medicine, some are asking if mandatory cutoff ages and cognitive and physical examinations are needed. More than 99,500 physicians in 2014 were still practicing in their 70s and beyond....The aging workforce is likely to become more noticeable in the years ahead. A 2015 report from the American Medical Association showed that poorer performance on quality measures such as mortality and length of stay were more apparent for clinicians age 60 and older, especially among those performing low volumes of the procedures. Its policymaking body, which consists of 540 physicians appointed by each state medical association and medical specialty association, is in the early stages of identifying research opportunities to inform preliminary guidelines for assessing senior and late-career physicians. Likewise, in January the American College of Surgeons recommended that surgical specialists undergo voluntary and confidential baseline physical examinations at regular intervals starting between ages 65 and 70.
I think that there is a need for more effective measures to identify physicians with age-related disabilities. Such measures obviously need to extend to both physical and cognitive problems. It make little sense to have mandatory retirement for, say, firefighters and air traffic controllers but not to pay attention to age-related physician problems. It is encouraging that the American College of Surgeons has recommended that surgeons undergo voluntary and confidential baseline physical examinations at regular intervals starting between ages 65 and 70. Obviously, other medical societies should follow this lead.
It should probably come as no surprise that the identification of impaired physicians is gaining some traction. Patients need some sort of protection and are becoming more vocal about healthcare services. Physicians are also increasingly employed by large health systems (see: A Fresh Look at Physician Employment by Hospitals). Hospitals have much more control over their physician employees than private practitioners with admitting and surgical privileges. Physicians employed by hospitals are also covered by the hospital malpractice insurance. I am sure that the insurance companies can require enhanced surveillance of the professional competence of these physicians. I view all of this as a positive trend although aging physicians who have their practice limited or terminated may not see view this issue in the same light.