Should hospitals require older docs to take competency tests?

Like asking senior citizens to take a driving test to get relicensed, some hospitals take on a controversial policy that requires older physicians to undergo fitness-for-duty evaluations to receive medical staff privileges, drawing questions as to whether it discriminates against senior-aged doctors.

About 5 percent of hospitals have age-based medical staff policies, according to Jonathan Burroughs, president and CEO of The Burroughs Healthcare Consulting Network in New Hampshire and contributor to the Hospital Impact blog. Burroughs recommended that hospitals require senior citizen doctors over the age of 70 who specialize in vocational or occupational medicine to undergo an evaluation during their annual renewal of privileges, American Medical News reported.

With more than half (52 percent) of physicians saying their retirement plans have changed since the recession hit, according to a Jackson & Coker survey last year, more physicians are practicing for longer these days. The decline of physical and cognitive abilities associated with age could have patient safety repercussions.

Although some physicians acknowledge the demands of practice and the limitations of age, some physicians may be resistant to give up working partly or completely. And when that's the case, it can fall on the hospital to take action.

"When there's a potential impairment that's not caused anyone harm, the solution too often is to turn the other way and hope nothing bad happens," Burroughs said. "If someone's starting to struggle, why not reach out to them and help them?"

Many of the doctors who are referred for competency evaluations by state medical boards and physician wellness committees are in their late 50s and early 60s, William Norcross, a geriatrician and executive director of the Physician Assessment and Clinical Education Program at the University of California, San Diego, said in the amednews article.

In addition to either recommending or mandating evaluations, hospitals can use other methods including focused professional practice evaluation (FPPE) and ongoing professional practice evaluation (OPPE) to ensure physicians are competent.

But it needn't take a lot of time. For instance, FPPE, now in its fifth year since The Joint Commission announced the medical staff rule, can pull from metrics that hospitals are already collecting, such as case reviews, core measures and complications, Rick Sheff, principal and chief medical officer of The Greeley Company in Massachusetts, noted Thursday in Medical Staff Leader Connection.

For more information:
- read the amednews article
- here's the Medical Staff Leader Connection column

Related Articles:
How to handle aging physicians
Safety comes with surgeons' age
Aging docs need regular evaluation to ensure competence
Some physicians facing test to renew certification

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