Should Doctors Be Tested for Competence at Age 65?

Leigh Page

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October 28, 2015

In This Article

What's an Appropriate Cutoff Age?

Dr Burroughs, a 65-year-old former emergency physician, thinks that hospitals should start testing doctors at his current age, because that's when age-based disabilities start to become pronounced in some physicians. But in his consultant role, he recommends age 70 years, and then seeks to reduce the age limit after the policy becomes more acceptable to physicians on staff.

"It has to do with 'change management,'" he says. "A lot of doctors on staff are in their 60s and are more likely to accept the policy if it's limited to older physicians."

Even at age 70, though, many physicians would be affected if every hospital had such policies. According to the Federation of State Medical Boards,[2] 64,000 physicians in their 70s had an active license in 2010.

What's more, the number of older physicians has been rising as the baby boom generation reaches retirement. According to the AMA,[3] the proportion of physicians aged 65 years or older rose from 9.4% in 1985 to 15.1% in 2011.

How would older physicians be tested? Under D Burroughs' approach, they would get a face-to-face "fitness to work" evaluation by a vocational specialist—someone who is trained to assess commercial airline pilots and other professionals. The evaluation takes about an hour and covers cognitive, metabolic, psychological, and physical domains. Doctors who have any possible deficits in any of these areas would be directed to a more intensive exam.

Dr Burroughs says the initial evaluation costs about $300-$500, which he thinks the hospital should pay for. Doctors identified as impaired in some way would confidentially work out a mutually agreed-upon resolution with hospital authorities on what work they could continue to perform. For example, an older doctor might agree not to take overnight call, deal with lengthy surgeries, or work long shifts.

Experts often mention the option of simply stopping doctors from practicing when they reach a specific age. For example, US commercial pilots are required to retire at age 65 years, and 15 years ago, some hospitals in Britain's National Health Service required surgeons to retire at age 65, but that policy has reportedly been rescinded.

Mandatory retirement would be easier to administer than testing programs, but experts have roundly rejected this option, noting that many physicians are quite capable of practicing into their 80s (such as famed cardiac surgeon Dr Michael E. DeBakey) and that forcing all older doctors to retire would hasten a looming physician shortage. Almost one third of physicians were 60 years of age or older in 2012, according to the Association of American Medical Colleges.[4]

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