Is My Doctor Too Old?

I am regularly asked by patients and others at what age should colonoscopies end.  Some patients inquire hoping that they are one year beyond the limit!

Other physicians face similar inquiries with regard to Pap smears, mammograms and other routine preventive tests. 

Turning the tables, I have even read opinion pieces asking if there should be a retirement age for physicians.  Commercial pilots have an upper age limit of age 65.  Should an octogenarian surgeon be allowed to operate on patients?  Federal judges have lifetime appointments.  Is the public well served by this?  There are at least two sides to this lifetime appointment policy.

Some argue for aging out folks in order to rejuvenate the ranks.  This makes sense.  Others argue that any individual who is competent should be permitted to continue working regardless of age.  Why should we jettison folks with decades of valuable experience just because a certain age has been reached? 

The issue becomes sticky when there are questions of competency, which the practitioner may deny, and are not that easy to assess.  Moreover, culling the professional herd of folks who may have started sloping downward is not that easy. How would you do it?  Who decides?  Would a minor cognitive slippage require revoking a medical license?

Perhaps, job descriptions can be modified to conform to some loss of certain abilities or functions.  However, this is not always possible.  

We will see this issue raised in the upcoming presidential election next year.  President Biden, who is assumed will the Democratic presidential candidate, would be 86-years-old at the conclusion of his 2^nd term.  I am offering no opinion on the president’s competency – but others will and I think this is fair game.  Should all elective officials, and perhaps the rest of us, be subjected to competency assessments?  Should such testing start at a certain age?

Measuring Physician Competency is Worse than Sausage Making

The medical profession, in contrast to the airline industry, has no age limits.  I’m not supportive of imposing a mandatory retirement age for doctors.  I do support medical practitioners demonstrating that they can practice their craft competently.  I don’t think that such a system is currently in place.  The continuing education requirements, which I support, do not address mental fitness and in my view do little with regard to demonstrating professional competency.  For those who perform surgeries or procedures, they need to be able to show that they have the requisite technical skills.  If an 80-year-old physician can still do the job, then the profession and his or her patients are enriched by this doctor’s continued participation.  And physicians with many decades of experience can pass on many lessons to younger colleagues.  Older physicians bring great value to the profession and to the public.

One thing is for certain.  Devising a system that can fairly and accurately measure physicians’ cognitive and technical skills in an effort to determine fitness to serve will make sausage making seem tame by comparison.  Any good faith proposal would be vulnerable to robust challenge by stakeholders.