As more physicians work beyond typical retirement age, hospitals and health systems must strike a balance between what are often opposing forces: keeping older doctors happy and keeping their patients safe.
Doctors themselves are split on the issue. Some say it’s a safety imperative to screen older physicians for cognitive and physical decline, while some consider it ageism, according to an article from the Philadelphia Inquirer. Some aging doctors, like Herbert Dardik, M.D., who is 82, come around after taking the tests.
Dardik, who works at Englewood Hospital and Medical Center in Bergen County, New Jersey, strongly resisted the tests at first but changed his mind when the outcome went his way. After passing the tests, Dardik said he realized their value.
“I came back convinced that it is a valuable program. It was a little more intense than it needed to be,” he told the newspaper. “This is something that all places should do.”
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Many of the health systems in and around Philadelphia have some kind of testing protocol for older doctors, according to the article. Penn Medicine is developing a test for cognitive decline that it will give to physicians over 70-years-old beginning next year.
Cooper University Health Care has a late-career policy for doctors over 72 that includes cognitive and physical tests. Temple Health is developing a policy, a spokeswoman told the newspaper.
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Some doctors may be less willing to accept testing policies than Dardik or other proponents. A group of doctors at Stanford has spent five years protesting its age-based policies, 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 wonder why competency tests can’t extend to all doctors.
Recent research from Harvard Medical School found higher mortality rates for patients treated by physicians aged 60 or older than those aged 40 or younger.
Mortality rates for inpatients within a month of admission were 12.1% compared to 10.8%, which accounted for one additional patient death per 77 treated for the older docs. The researchers said the results are “modest yet clinically meaningful.”