Most workers have felt the sting of the recent recession, and many have delayed their retirement in order to keep generating much-needed income and to save for the future. However, what happens to the quality of patient care when doctors, especially those in high-risk and demanding fields like surgery, continue practicing into their 70's and beyond?
According to a recent survey, 52 percent of doctors have changed their retirement plans since the start of the recession. Further, in 2010, 20 percent of licensed U.S. physicians were older than 65. Yet, currently, only approximately 5 percent of hospitals have age-based medical staff rules in place, and a preponderance of doctors referred for competency evaluations are only in their late 50s and early 60s.
While it is true that not all doctors' abilities decline with age, the general trend for all people is a deterioration of cognitive abilities as they age, with people in their 70s generally taking twice as long to complete mental tasks as those in their 20s. In addition, a 2005 Annals of Internal Medicine review found that a majority of studies have shown that a doctor's abilities declined in relation to his or her age.
There are some measures being taken to ensure public safety in this arena. The American Board of Medical Specialties (ABMS) is now requiring maintenance-of-certification programs and other boards are following suit. However, these programs are not designed to discover cognitive decline, and many older doctors are exempt from the programs.
There are safeguards that hospitals can put in place to protect patients without discriminating against older doctors. One option is hospital-mandated reviews of privileges for doctors over 70 determined by fitness-for-duty evaluations. Such evaluations could include the computer-based cognitive function test that is currently used to evaluate airline pilots and screen for Alzheimer's disease.
Another possibility is specific professional practice evaluations in order to determine competency.
While it is understandable that many doctors may want to continue in their profession for as long as possible, the stakes for their mistakes are higher than in most other areas and, therefore, their competency needs to be held to the highest scrutiny.
Source: Fierce Healthcare, "Should hospitals require older docs to take competency tests?," 7/31/2012
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