The story uses horror stories such as the opener about a 78 year old surgeon who had visual and cognitive defects causing the death of a patient. Some recommend periodic testing of “older” doctors, similar to what airlines and the FAA do to pilots starting at age 40. It also cites mandatory retirements of other fields at age 65, but notes the medical profession chafes at this proposal for physicians.
As the article states, one-fifth of all practicing US physicians are already over 65 years now. We face that infamous looming shortage of 150,000 doctors by the year 2025.
My question for all of us future physician leaders is: How do we ethically and practically balance these competing factors? And what other issues do you see here?
The need for more doctors
The current trend of many doctors staying in practice longer to meet personal financial needs
American society's need for more doctors to keep on working to avoid the worst of the predicted physician shortage
Our own self-interest to be allowed to practice 25 to 30 years, in view of our delayed start dates as OPMs
Patient safety issues possibly arising from lowered capacity of some older practitioners -- however rare and anecdotal those stories may be
Possible ageism and bias against older physicians, when only a few may deserve review or removal
I wish I could post the whole story here but copyright laws prohibit it. This is a vital area for any "Old Pre-Med" or "Older Medical Student" to contemplate their newfound careers being foreshortened by bureaucratic efforts, fueled by such "scare tactics."
Hope to generate a lot of comment on this, and see if anyone here thinks we should advocate one way or the other on this public issue.
First off if age is that much of an issue then I guess we should start limiting a lot of things to people over the age of 65.
Secondly, most folks who face a mandatory retirement at 65 have a really nice pension system to take care of them, what are Dr’s. supposed to do retrain?
The article says that some specialties are imposing new age-related testing (competency / cognitive?) on newly board certified physicians, while grand-personing in those already in practice (i.e., the oldsters). So it is not merely a possibility – but already begun.
To counter the bias of widespread age-related impairments: For OPM’s, this seems like the reverse logic applies to us – even more than the straight-from college 22 year olds:
Why? If we are bright and alert enough at our advanced years to accomplish more pre-med academics, score well on the MCAT and succeed in the whole 4-year medical school curriculum at ages 30’s - 40’s - 50’s and even 60’s by the time some of us are done training:
Then obviously we are anything but impaired! We’ve still got what it takes!
Personally, I would even use that to respond to any hopefully rare confrontational admissions interview question about: Why should this AdCom and SOM believe you can make it at your age?
I can see age being an issue for a surgeon. That is physically demanding work. Hunched over for long periods, sometimes requiring moving a patient around, hold up arms, legs, etc. I know a couple of orthopedists that have backed off and do easier work as they got older. The guy that patched me up now is only a rehab specialist. Another won’t do the long procedures anymore. No total knee and hips for example. It’s going to be different for everyone though… An example:
Imagine how many people might not be around now if someone had told Dr. Michael DeBakey to hang it up when he hit 70. The guy didn’t hang up his scalpel till he was 90! Performed over 60,000 heart surgeries in his time.
Wow, thanks for posting bout Dr. DeBakey! I keep a folder for constant inspiration on my computer titled, Age No Barrier To Productive Life. It has dozens of older public figures and unsung heroes / heroines of advanced years, but your DeBakey life bio tops most other entries. While I knew all about his surgical and inventive career, I had no idea he worked, did surgeries and taught other surgeons into his 90’s. Brilliant!
Last year when I was considering surgery, I found an article that showed that age was less important than, the volume the surgery was preformed by the surgeon.
So, if the surgeon does this thing all the time, no worries. If the surgeon hasn’t done this procedure for ‘a few years’, worry.
The study also states that in internal medicine disciplines, physician performance improves with age.
I am no longer considering doing surgery, because the residency will personally kill me, but my age when I start practicing is not my limiting factor.
(Even though a snarky surgeon tried to convince me that it would take me another 10 years to perfect my technique. I bit my tongue not saying that since I already have years experience producing sculpture, I might be a little faster out of the starting gates. )
my favorite story I have heard is about a Neurologist that practiced for a number of months (due to his excellent staff) without being to remember that the thing he was wearing on his neck was called a “tie” or being to pass other various tests.
When people get old sometimes they lose their abilities to do things. That happens in all professions.
People are free to go see a 30yr old Physician if they don’t want to see a 75yr old one. If they want they can usually chose not to see a physician at all.
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