COMMENTARY

Mental Decline in Older Physicians: When Do You Stop?

Brandon Cohen

Disclosures

October 03, 2012

In This Article

Physicians Talk About the Aging Brain

Should aging doctors undergo mandatory cognitive testing? This question, posed in a recent discussion on Medscape's Physician Connect, an all-physician discussion group, sparked wide interest, tense exchanges, and some genuine soul-searching: "Do you feel that the large population of aging physicians presents a safety concern for patients? If so, what should be done about it?"

Turning the Tables of Time

"Do you feel that doctors over the age of 65 should be screened for cognitive decline?" began a general practitioner.

Many, particularly those who identified as older doctors, chafed at any suggestion of testing for aging physicians. "I am appalled at the notion of cognitive testing. I do not plan to retire until I sense I am losing my touch," said one 70-year-old internist.

More than a few physicians flipped the script, pointing out the shortcomings of younger colleagues.

"I'll take a thoughtful history, skilled physical exam, and decades of experience over some young pup who stares at the computer screen and asks questions from a list of checkboxes... If my clinical skills fell to [that level] I'd retire voluntarily. It's not the older physicians who are threatening patient safety," said a pediatrician.

"I am 67 and chair a multispecialty peer-review committee. The vast majority of complaints are not against the elderly physicians but against the young (naively intelligent) docs," said an ob/gyn.

A general practitioner continued in this vein, writing, "There are a lot of younger physicians out there who have substance abuse problems, mental illness, etc., who probably represent a far greater danger to patients than your average 70-year-old physician."

"The young ones here will change their minds as they get older," an experienced radiologist predicted.

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