Aging Doctors

The image of an older doctor, for many people, is a comforting one. After all, with age comes experience, and older doctors are likely to have seen and treated a wider variety of symptoms and conditions than younger, less experienced doctors. But as many doctors themselves know, older people often miss or ignore the signs of dementia and other age-related disorders that may harm a doctor’s performance. And according to some critics of our health-care system, even perfectly healthy older doctors may be more likely to offer outdated treatments and techniques than their younger counterparts. (When it comes to Type 2 diabetes, for example, some doctors may initially prescribe an older drug rather than metformin if diet and lifestyle changes fail to adequately control blood glucose levels.)

An article published last month in the Washington Post explored these and other issues related to the aging of doctors. According to the article, 42% of practicing doctors in the United States are older than 55 — up from 35% just six years ago — and 21% of doctors are older than 65. Unlike airplane pilots and FBI agents, doctors face no mandatory retirement age, nor are there even periodic evaluations that doctors must pass to retain their medical licenses. While most states require doctors to attend continuing education classes periodically, there are virtually no procedures in place to ensure that doctors understand or even pay attention to what is being taught.

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In response to this perceived lack of safeguards, some prominent hospitals and medical groups, including Stanford Hospitals and Clinics in California and the University of Virginia Health System, have begun to require doctors over a certain age (75 at Stanford, 70 at Virginia) to undergo physical and mental examinations. One health-care consultant quoted in the article estimates that only 5% to 10% of medical institutions have such procedures in place. Since the policy was put in place at the University of Virginia, 28 of 35 doctors over age 70 easily passed their examinations, while the remaining 7 decided to retire instead of participating. The retired doctors remain free to practice medicine outside of the University’s health system.

Some hospital administrators don’t agree that age-based safeguards are necessary. One executive at MedStarHealth, the largest hospital network in Washington, DC, and Maryland, argued in the Post article that regular performance evaluations are enough to weed out any doctors who experience age-related decline. Most hospitals, in fact, review performance data about every two years and may decide at that time not to renew a doctor’s privileges. But critics argue that older, less competent doctors may slip through the cracks in these reviews and deserve special scrutiny. A surgeon at the Johns Hopkins Hospital in Maryland argues that since older doctors may not be up-to-speed on the latest treatments and procedures, they should be subject to more oversight than younger doctors.

Of course, whatever age-based screening procedures are adopted by hospitals or medical groups, they cannot stop doctors who leave from continuing to practice elsewhere. And doctors in private practice are probably unlikely to screen themselves for age-related decline.

What do you think — should states adopt screening procedures for older doctors, or set a mandatory retirement age? Should hospitals and medical practices single out older doctors for special scrutiny, or should performance evaluations be standard regardless of age? Would you feel comfortable seeing an older doctor or a younger one — or does age play no role in your comfort level? Have you ever seen an older doctor who you suspect was out of touch with the latest medical knowledge? Leave a comment below!

  • HTT

    I don’t agree with age based screening. Just being young does not guarantee that a doctor is skilled or up on all the latest techniques. If screening is put in place it should apply to all doctors, not just the older ones. I have run into my fair share of incompetent and/or arogant doctors who do not “listen” to their patients, both old and young. If a measurement is to be applied, then it should apply to all.

  • Susan Warren

    of even more concern is the MD who has “retired” in spirit and mentality although continues to practice 3-4 days or part days a week. As a nurse, I can detect their robotic responses, lack of engagement, and inability to keep up with minimum standards of care. I believe this is of more concern in tourist locations, for instance, I live in Santa Fe where many retire, but chose to work a few days a week, much to the detriment of unsuspecting patients. True of dentists also.
    Whethèr to this or dementia, I recently experienced an ophthalmologist who, during an annual exam, commented on the fact I had signs of acute angle glaucoma and proceeded to dilate my eyes anyway, sending me on my way with no cautionary mention of signs or symptoms to look for. Thus, when I became ill within 2 hrs., increasing to severe symptoms (on a week-end), I had no idea what could be wrong- 4 days later with sever dehydration and passing out in the bathroom, I was dx. with acute angle closure as well as irreparable damage to my vision. Either cognitive decline or a semi retired mentality caused this medical mismanagement.

  • Tony Mumbazza

    One more time, big hospital trying to get rid of experienced Doctors, to privilige, young fresh from college, for the simple reason of been cheaper.

  • Becky

    My mother’s doctor failed to diagnose my father’s dementia until it was well advanced and I had to insist he take it seriously. He also said medication wouldn’t help and wouldn’t prescribe anything until we insisted. The medication gave us 2 1/2 more years of conversation with Dad. He refused to tell my dad he couldn’t drive anymore nor would he refer him to a neurologist. He failed to have my mother’s supposedly sprained ankle re-x-rayed resulting in the improper healing of a crushed heel bone. He is in his early 60’s and I wish he would retire because my mother won’t go to anyone else. However, I think he would pass most competency tests even though he doesn’t seem to be up on newer medications and treatments.