Some hospitals are screening older physicians for cognitive decline in the name of patient safety, but older doctors say such policies are ageist and may not actually determine if they can practice medicine.
Ann Weinacker, M.D., vice chair of medicine at Stanford Health, who has helped oversee such programs at the system, told The Wall Street Journal that physicians are not immune to the impacts of aging and that it’s important to screen for signs of cognitive issues like dementia. And physicians did push back against the process at Stanford, she said.
“It’s not for the faint of heart, this policy,” Weinacker said.
A group of doctors at Stanford have spent five years protesting its age-based policies, according to the article, with many older doctors simply refusing to take the cognitive tests. One change Stanford Health has made in the wake of the criticism is to include peer reviews in their analysis. But older physicians question why competency tests can’t extend to all doctors.
Weinacker said Stanford tests younger physicians as well when there are concerns about conduct, but that testing every doctor across the system is not feasible.
Recent research has found that patients may face worse outcomes when treated by older physicians. A Harvard study found that doctors aged 60 and over accounted for one more patient death per 77 treated, and also linked care by older physicians to increased costs.
The conclusion of that study team was not necessarily that older doctors were losing mental capacity, but they may be behind in the latest medical innovations. Study author Anupam Jena, an associate professor of healthcare policy at Harvard, said it’s important that doctors continue education and training throughout their careers.
"Older physicians bring invaluable richness of knowledge and depth of experience, yet their clinical skills may begin to lag behind over time," he said.
Major medical organizations like the American Medical Association have come out in favor of screening older doctors. The number of physicians over the age of 65 has quadrupled since 1975, and now nearly a quarter of doctors are in that age group. Forty percent still practice medicine actively, according to the article.