I found this article fascinating and applauded the AMA for adopting a plan to help decide when it’s time for senior physicians to retire. Now, it is not known what the age will be, but just that they are addressing this concern is a good step. The group want to create competency guidelines for evaluating whether older physicians remain able to provide safe and good care for patients. Currently, all doctors must meet state licensing requirements, and some hospitals require age-based screening. But there are no national mandates or guidelines on how to make sure older physicians can still do their jobs safely. Why do they want to do this? They report that the number of U.S. physicians aged 65 and older has quadrupled since 1975 and now numbers 240,000. Without debate, the AMA voted that the evaluation should include physical and mental health and a review of doctors’ treatment of patients. What the report doesn’t address is who would do the assessing nor how often it would take place. As the report acknowledged, “Unfortunate outcomes may trigger an evaluation at any age, but perhaps periodic reevaluation after a certain age such as 70, when incidence of declines is known to increase, may be appropriate.” The AMA’s Council on Medical Education wrote the report and says “physicians should be allowed to remain in practice as long as patient safety is not endangered.” Developing guidelines and standards for monitoring and assessing both their own and their colleagues’ competency “may head off a call for mandatory retirement ages or imposition of guidelines by others,” the report says. Typical age-related changes in hearing, vision, memory and motor skills all could potentially affect physicians’ competence, the report says, but notes there is no evidence that directly links these changes to worse outcomes for patients. As you would expect, many elderly doctors are not in favor of this plan or the potential for extra scrutiny. It’s a touchy topic for older doctors, and not all welcome the prospect of extra scrutiny.
U.S. physicians must be licensed to practice in the state where they work and requirements generally include an evaluation of medical education and training, malpractice and discipline history. Licenses must be renewed yearly or every two years; but no competency exams are required after initial licensure, regardless of the doctor’s age. The Joint Commission, a private accrediting group, requires U.S. hospitals to periodically evaluate physicians’ performance. Most hospitals do these evaluations every nine months for physicians of all ages, said Dr. Ana McKee, the commission’s chief medical officer.
The University of Virginia Health System is one of the institutions that require additional scrutiny of older doctors. Their screening began in 2011 for doctors and some other medical staff starting at age 70 and involves physical and cognitive exams every two years. “The vast majority of them score very well,” said Dr. Scott Syverud, chair of the university medical center’s credentials committee.Those who don’t “can choose to cut down their practice or even to retire,” Syverud said, although he declined to say if any have been deemed incompetent.
Syverud, 58, said the screening began not because of any incident, but because “we are all aging practitioners, including me. It’s good to have an independent check that we are still capable” of providing competent care.