For a physician, does aging count?
February 7, 2011
If you think there is an internal mechanism to protect you from incompetence at the hands of an aging doctor, think again. Doctors are not immune to the ills of aging, including dementia, Parkinson’s disease and stroke. But, for the most part, incompetence doesn’t surface until a state medical board institutes disciplinary action. According to The New York Times, January 24, 2011, “In 2006, a study found that in complicated operations, patients’ mortality rates were higher when the surgeon was 60 or older, though there was no difference between younger and older doctors in routine operations.”
Commercial pilots must retire at age 65. They also undergo physical and mental exams every six months, starting at age 40. So, what about doctors? Thus far, no such uniform mechanism exists. Diane Pinakiewicz, president of the National Patient Safety Foundation, urges that we systematically and periodically evaluate physicians. A small group of hospitals screen their older physicians and some specialty boards require recertification every 7 to 10 years. But such oversight has met with resistance.
Dr. Henry Homburger, 64, professor at the Mayo Clinic, believes that factors such as depression, mental illness and a failure to pursue continuing education outweigh aging in terms of poor performance. But according to Dr. William Norcross, director of physician assessment at the University of California, San Diego, “You can be asleep during those courses and no one would know.”
Medical professionals are supposed to report colleagues who are performing poorly, but doctors may cover for one another, avoiding the hard calls, especially when the doctor with questionable performance may be the senior who trained them. Doctors have been known to shelter the “less sharp” by having another surgeon in the operating room.
Dr. Jonathon Burroughs, hospital and health care company advisor believes a screening process for aging physicians is actually the most compassionate route. If there’s a problem, the doctor’s practice can be modified to include a decreased patient load and frequent monitoring. Monitoring may prevent an adverse event, resulting in total license removal.
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