Mandatory Retiring Age for Physicians

[Small Cell Carcinoma]

Anyone else think that doctors should have a mandatory retirement age (especially for procedure oriented specialties)? Considering the overwhelming research that suggest that one's fine dexterity and overall cognition decrease dramatically after age 65, it seems surprising that state and federal governments do not have any laws in place to this effect. Other professions that are responsible for peoples' lives have policies in place that require a mandatory retirement by a certain age (i.e. air traffic controllers @ 55), so it seems surprising to me that a surgeon who is pushing 80 is still allowed to practice without restrictions. In my short time in medicine, I've worked with at least a dozen doctors over 70, some of whom seem to have early signs of dementia and frequent lapses in concentration/stamina. Many of them also display a strong resistance to learning how to use electronic medical records properly (even met one attending who refused to own a cellphone) which inevitably decreases efficiency/productivity. Anyone who has been in practice for decades can passively regurgitate what is needed to pass the boards every 10 years, but I feel like this still does not accurately determine whether a elderly physician is competent to practice safely. Not that I don't have anything but respect for senior physicians, but I can definitely see this as becoming a public safety issue that can very easily be overlooked given the overall culture of medicine. Curious to hear what others think on this issue.

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[VA Hopeful Dr]

Anyone else think that doctors should have a mandatory retirement age (especially for procedure oriented specialties)? Considering the overwhelming research that suggest that one's fine dexterity and overall cognition decrease dramatically after age 65, it seems surprising that state and federal governments do not have any laws in place to this effect. Other professions that are responsible for peoples' lives have policies in place that require a mandatory retirement by a certain age (i.e. air traffic controllers @ 55), so it seems surprising to me that a surgeon who is pushing 80 is still allowed to practice. In my short time in medicine, I've worked with at least a dozen doctors over 70, some of whom seem to have early signs of dementia and frequent lapses in concentration/stamina. Curious to hear what others think on this issue.

No, but I wouldn't object to periodic cognitive testing past a certain age

 

[IMG69]

I've worked with maybe five 80 year old surgeons, good thing they were due to retire in a year or two, one nicked the liver quite badly during a lap chole and WE had to point out it was hemorrhaging significantly.

 

[Neopolymath]

If we did cognitive testing and MRI after a certain age, I think we would be surprised just how many people should not be working clinically. Maybe it would encourage better financial skills too.

 

[7331poas]

Maybe in surgery.

For the record, I hate EMR too so...

 

[deleted480308]

Anyone else think that doctors should have a mandatory retirement age (especially for procedure oriented specialties)? Considering the overwhelming research that suggest that one's fine dexterity and overall cognition decrease dramatically after age 65, it seems surprising that state and federal governments do not have any laws in place to this effect. Other professions that are responsible for peoples' lives have policies in place that require a mandatory retirement by a certain age (i.e. air traffic controllers @ 55), so it seems surprising to me that a surgeon who is pushing 80 is still allowed to practice without restrictions. In my short time in medicine, I've worked with at least a dozen doctors over 70, some of whom seem to have early signs of dementia and frequent lapses in concentration/stamina. Many of them also display a strong resistance to learning how to use electronic medical records properly (even met one attending who refused to own a cellphone) which inevitably decreases efficiency/productivity. Anyone who has been in practice for decades can passively regurgitate what is needed to pass the boards every 10 years, but I feel like this still does not accurately determine whether a elderly physician is competent to practice safely. Not that I don't have anything but respect for senior physicians, but I can definitely see this as becoming a public safety issue that can very easily be overlooked given the overall culture of medicine. Curious to hear what others think on this issue.

I think cell phone use and tolerating an emr are crappy criteria for “too demented to practice safely”

 

[Small Cell Carcinoma]

I think cell phone use and tolerating an emr are crappy criteria for “too demented to practice safely”

Didn't mean for it to come across that way. But I will say that older doctors are compromising their efficiency and overall level of teamwork when they decide to blatantly disregards things such as smart phones that unanimously improve the lives of everyone in a health oriented job. At the very least it says something about having a stubborn character, but on the other side, it can also suggest they fundamentally lack the abilities to gain a rudimentary mastery of these information platforms that are now used everywhere in hospitals.

 

[Chibucks15]

With the loan burden I’ll have idk if I’ll ever get to retire...

 

[Tenk]

Congress first, physicians last.

 

[deleted480308]

Didn't mean for it to come across that way. But I will say that older doctors are compromising their efficiency and overall level of teamwork when they decide to blatantly disregards things such as smart phones that unanimously improve the lives of everyone in a health oriented job. At the very least it says something about having a stubborn character, but on the other side, it can also suggest they fundamentally lack the abilities to gain a rudimentary mastery of these information platforms that are now used everywhere in hospitals.

Stubborn is far different than too dangerous to be around patients

I feel like you haven’t particularly thought this one all the way through

 

[Mass Effect]

Not that I don't have anything but respect for senior physicians

LOL

 

[ACSurgeon]

Congress first, physicians last.

and Supreme Court judges. And presidents.

 

[Mass Effect]

No, but I wouldn't object to periodic cognitive testing past a certain age

Unless there is evidence of incompetent care, I would strongly oppose such a measure.

 

[Mass Effect]

If we did cognitive testing and MRI after a certain age, I think we would be surprised just how many people should not be working clinically. Maybe it would encourage better financial skills too.

If we did cognitive testing and MRI on every physician, I think we would be surprised just how many people should not be working clinically, including many on the younger side.

 

[Mass Effect]

Didn't mean for it to come across that way. But I will say that older doctors are compromising their efficiency and overall level of teamwork when they decide to blatantly disregards things such as smart phones that unanimously improve the lives of everyone in a health oriented job. At the very least it says something about having a stubborn character, but on the other side, it can also suggest they fundamentally lack the abilities to gain a rudimentary mastery of these information platforms that are now used everywhere in hospitals.

Smart phones unanimously improve the lives of everyone in a health-oriented job?? What does that even mean? Where's the evidence that my 30-something life has been improved by using a smartphone in the clinical setting? And I think it's insane that would you suggest anyone who doesn't like EMR is compromising teamwork when the many doctors agree that EMRs suck and negatively impact efficiency.

 

[VA Hopeful Dr]

Unless there is evidence of incompetent care, I would strongly oppose such a measure.

I wonder if once all the grandfathered physicians retire if MOC for BC will lower the median retirement age.

I know of several physicians locally who when it came time to retake their board exam in their mid-to-late 60s decided that's what they wanted to retire because they didn't want to do that again.

 

[Mass Effect]

I wonder if once all the grandfathered physicians retire if MOC for BC will lower the median retirement age.

I know of several physicians locally who when it came time to retake their board exam in their mid-to-late 60s decided that's what they wanted to retire because they didn't want to do that again.

Yeah, I can see that. I might do that too if I have to do MOC in my late 60s.

But I think state medical boards already have too much power in a physician's life and career and it would take a seriously compelling argument for me to agree to letting them have more. Any dangerous or incompetent physician should be dealt with and stripped of their license, but age alone should not determine fitness to practice nor mandatory cognitive testing.

 

[Neopolymath]

If we did cognitive testing and MRI on every physician, I think we would be surprised just how many people should not be working clinically, including many on the younger side.

Sure you are probably correct but I think saying at 70 we make some hoops to jump through isn't wrong and it would be feasible. I believe some departments already do so.

 

[VA Hopeful Dr]

Yeah, I can see that. I might do that too if I have to do MOC in my late 60s.

But I think state medical boards already have too much power in a physician's life and career and it would take a seriously compelling argument for me to agree to letting them have more. Any dangerous or incompetent physician should be dealt with and stripped of their license, but age alone should not determine fitness to practice nor mandatory cognitive testing.

I guess I'm biased living in the state with the most lenient board in the country, but the state board is one of the least of my concerns.

That said, I don't think they should be the ones doing any testing. If it were to be done (and I'm fairly ambivalent on the issue), it should be done by an employer/hospital. If you're in solo practice and don't do anything outside that practice your potential for harm is significantly less (no ORs/ERs/inpatients).

I also think MOC would cut down on this significantly since if you are older and still practicing, you have to at least give the appearance of keeping current. One of the most incompetent FPs I've ever seen is in his 70s and let his BC lapse 8 years ago. Conversely, I know a practice with 3 FPs the youngest of whom is 69 and they are all fine and coincidentally are all still BC meeting MOC.

 

[Mass Effect]

Sure you are probably correct but I think saying at 70 we make some hoops to jump through isn't wrong and it would be feasible. I believe some departments already do so.

I think it IS wrong. Which departments already do this?

 

[Neopolymath]

I think it IS wrong. Which departments already do this?

I don't remember off hand but this was discussed in the anesthesia and radiology subforums I believe.

 

[Mass Effect]

I guess I'm biased living in the state with the most lenient board in the country, but the state board is one of the least of my concerns.

That said, I don't think they should be the ones doing any testing. If it were to be done (and I'm fairly ambivalent on the issue), it should be done by an employer/hospital. If you're in solo practice and don't do anything outside that practice your potential for harm is significantly less (no ORs/ERs/inpatients).

I also think MOC would cut down on this significantly since if you are older and still practicing, you have to at least give the appearance of keeping current. One of the most incompetent FPs I've ever seen is in his 70s and let his BC lapse 8 years ago. Conversely, I know a practice with 3 FPs the youngest of whom is 69 and they are all fine and coincidentally are all still BC meeting MOC.

Yes, your outlook is likely colored by your knowledge of your own medical board. But trust me when I tell you that isn't the national outlook. As a psychiatrist, Ive had to do many fitness for duty evals of other healthcare providers and the reach of the medical boards in many states is insane and violates ADA in my view.

And it would be impossible to make it a hospital's responsibility when we're talking about licensing. Licensing is through the state board likely with recommendations through scummy and corrupt physician health programs.

 

[curbsideconsult]

Supreme Court judges

Don't you dare remove the notorious RBG from her throne seat.

 

[Mass Effect]

I don't remember off hand but this was discussed in the anesthesia and radiology subforums I believe.

So you can't cite it then? Regardless I stand by what I said. It's wrong and should not be a thing unless cognitive testing is going to be part of getting a medical license for ALL physicians.

 

[Neopolymath]

So you can't cite it then? Regardless I stand by what I said. It's wrong and should not be a thing unless cognitive testing is going to be part of getting a medical license for ALL physicians.

I didn't realize I was presenting to an attending on rounds. Simmer down. Perhaps I will find time to look it up later today. It's really no consequence to me if you don't believe me lol. I'm completely ok with that.

 

[Mass Effect]

I didn't realize I was presenting to an attending on rounds. Simmer down. Perhaps I will find time to look it up later today. It's really no consequence to me if you don't believe me lol. I'm completely ok with that.

It's not a matter of me believing you or me being an attending or anything else. We're having a conversation about requirements for older physicians and you're telling me this already happens, but can't give me any details about it, so it's irrelevant to the conversation. I could be a pre-med and I'd still say the same.

It would be like me saying this is illegal, but being unable to cite any kind of source for saying that. You'd likely tell me the same.

 

[Neopolymath]

It's not a matter of me believing you or me being an attending or anything else. We're having a conversation about requirements for older physicians and you're telling me this already happens, but can't give me any details about it, so it's irrelevant to the conversation. I could be a pre-med and I'd still say the same.

It would be like me saying this is illegal, but being unable to cite any kind of source for saying that. You'd likely tell me the same.

Yale aged physician policy

Our medical staff just implemented a similar policy. A couple of our surgeons were complaining about it. My group has a mandatory retirement age. https://www.eeoc.gov/eeoc/newsroom/release/2-11-20a.cfm

forums.studentdoctor.net

This is the main example I was thinking of

 

[Mass Effect]

Yale aged physician policy

Our medical staff just implemented a similar policy. A couple of our surgeons were complaining about it. My group has a mandatory retirement age. https://www.eeoc.gov/eeoc/newsroom/release/2-11-20a.cfm

forums.studentdoctor.net

This is the main example I was thinking of

Let's see what happens in court. Regardless though, I still think it's bad policy. One way around it is to give all doctors cognitive testing, regardless of age.

 

[Candidate2017]

In my short time in medicine, I've worked with at least a dozen doctors over 70, some of whom seem to have early signs of dementia and frequent lapses in concentration/stamina.

To be fair, I've worked with lots of med students who are forgetful and have frequent lapses in concentration/stamina.

 

[Candidate2017]

Many of them also display a strong resistance to learning how to use electronic medical records properly (even met one attending who refused to own a cellphone) which inevitably decreases efficiency/productivity.

Are you sure you don't work for hospital admin or an EMR company? If not, give it some time and you'll develop a strong resistance to even carrying a pager.

 

[Mad Jack]

Anyone else think that doctors should have a mandatory retirement age (especially for procedure oriented specialties)? Considering the overwhelming research that suggest that one's fine dexterity and overall cognition decrease dramatically after age 65, it seems surprising that state and federal governments do not have any laws in place to this effect. Other professions that are responsible for peoples' lives have policies in place that require a mandatory retirement by a certain age (i.e. air traffic controllers @ 55), so it seems surprising to me that a surgeon who is pushing 80 is still allowed to practice without restrictions. In my short time in medicine, I've worked with at least a dozen doctors over 70, some of whom seem to have early signs of dementia and frequent lapses in concentration/stamina. Many of them also display a strong resistance to learning how to use electronic medical records properly (even met one attending who refused to own a cellphone) which inevitably decreases efficiency/productivity. Anyone who has been in practice for decades can passively regurgitate what is needed to pass the boards every 10 years, but I feel like this still does not accurately determine whether a elderly physician is competent to practice safely. Not that I don't have anything but respect for senior physicians, but I can definitely see this as becoming a public safety issue that can very easily be overlooked given the overall culture of medicine. Curious to hear what others think on this issue.

I mean, in psychiatry practicing into your 70s is pretty routine...

In procedural specialties, maybe test hand-eye coordination periodically or something, but mandatory retirement seems ridiculous when we don't have enough people doing procedures as-is

 

[Splenda88]

So you can't cite it then? Regardless I stand by what I said. It's wrong and should not be a thing unless cognitive testing is going to be part of getting a medical license for ALL physicians.

This is definitely a nono...

 

[VA Hopeful Dr]

Yes, your outlook is likely colored by your knowledge of your own medical board. But trust me when I tell you that isn't the national outlook. As a psychiatrist, Ive had to do many fitness for duty evals of other healthcare providers and the reach of the medical boards in many states is insane and violates ADA in my view.

And it would be impossible to make it a hospital's responsibility when we're talking about licensing. Licensing is through the state board likely with recommendations through scummy and corrupt physician health programs.

I wasn't thinking licensing, I was thinking hospital privileges. As I said, if you're not operating or dealing with ED/inpatients, the amount of harm you can do is significantly reduced.

 

[Splenda88]

Are you sure you don't work for hospital admin or an EMR company? If not, give it some time and you'll develop a strong resistance to even carrying a pager.

Pager--the bane of my existence in residency...

 

[Splenda88]

I mean, in psychiatry practicing into your 70s is pretty routine...

In procedural specialties, maybe test hand-eye coordination periodically or something, but mandatory retirement seems ridiculous when we don't have enough people doing procedures as-is

Because you guys have the easiest job in the world 😛 (joke)..

 

[Mass Effect]

I wasn't thinking licensing, I was thinking hospital privileges. As I said, if you're not operating or dealing with ED/inpatients, the amount of harm you can do is significantly reduced.

Leaving it up to hospital hiring practices will almost definitely be challenged (and likely won) in court.

 

[Mad Jack]

Because you guys have the easiest job in the world 😛 (joke)..

If only...

 

[VA Hopeful Dr]

Leaving it up to hospital hiring practices will almost definitely be challenged (and likely won) in court.

No question

 

[Ho0v-man]

Yay, a discussion about even further regulating some of the most diligently trained people in the world. If I’ve learned anything through this process it’s that if someone thinks you’re not doing your job well, you’ll hear about it.

God, we keep making training longer and longer and now we’re going to restrict how long we can even do it? I’m sure there’s examples of physicians doing this stuff. But I think most of us are smart enough not to try to work like a resident when we’re in our 60s. But even if we want to do that, as long as we’re certified to do so we should be allowed to do the thing we basically devoted our lives to doing.

 

[Splenda88]

Yay, a discussion about even further regulating some of the most diligently trained people in the world. If I’ve learned anything through this process it’s that if someone thinks you’re not doing your job well, you’ll hear about it.

God, we keep making training longer and longer and now we’re going to restrict how long we can even do it? I’m sure there’s examples of physicians doing this stuff. But I think most of us are smart enough not to try to work like a resident when we’re in our 60s. But even if we want to do that, as long as we’re certified to do so we should be allowed to do the thing we basically devoted our lives to doing.

One thing you will learn about medicine is that physicians love to be regulated by "outside" entities that use us as their financial coffer

 

[Mass Effect]

One thing you will learn about medicine is that physicians love to be regulated by "outside" entities that use us as their financial coffer

Nah, physicians don't love being regulated. The majority of physicians are focused on providing care patients, the skillset they paid quarter of a million dollars to learn while money-seeking and/or power-hungry and/or poor-judgment colleagues acquire more and more power and make questionable decisions, including more regulations.

 

[VA Hopeful Dr]

Nah, physicians don't love being regulated. The majority of physicians are focused on providing care patients, the skillset they paid quarter of a million dollars to learn while money-seeking and/or power-hungry and/or poor-judgment colleagues acquire more and more power and make questionable decisions, including more regulations.

Bingo. It's why cash only is getting more and more popular

 

[Naruhodo]

Nope, especially as some of us started this journey later in life. I hope to be practicing until I'm at least 70 in order to become expert and make meaningful contributions in my chosen field. Our Dean gave a lecture once showing that for our institution the most productive reseach decade in terms of high-impact publications is 65-74. Sure, you could argue this is because they are senior PIs and that younger people are doing a lot of that work, but still they are at the head of those labs and paying for those more junior people/ orchestrating the projects they work on. Even among clinicians, some of my favs are in their 70s and have relationships spanning decades with patients who adore them. They're often old-school, but win teaching prizes for a reason.

 

[cookiegrub]

Anyone else think that doctors should have a mandatory retirement age (especially for procedure oriented specialties)? Considering the overwhelming research that suggest that one's fine dexterity and overall cognition decrease dramatically after age 65, it seems surprising that state and federal governments do not have any laws in place to this effect. Other professions that are responsible for peoples' lives have policies in place that require a mandatory retirement by a certain age (i.e. air traffic controllers @ 55), so it seems surprising to me that a surgeon who is pushing 80 is still allowed to practice without restrictions. In my short time in medicine, I've worked with at least a dozen doctors over 70, some of whom seem to have early signs of dementia and frequent lapses in concentration/stamina. Many of them also display a strong resistance to learning how to use electronic medical records properly (even met one attending who refused to own a cellphone) which inevitably decreases efficiency/productivity. Anyone who has been in practice for decades can passively regurgitate what is needed to pass the boards every 10 years, but I feel like this still does not accurately determine whether a elderly physician is competent to practice safely. Not that I don't have anything but respect for senior physicians, but I can definitely see this as becoming a public safety issue that can very easily be overlooked given the overall culture of medicine. Curious to hear what others think on this issue.

I'm having a hard time believing why this can be positive with the current laws and regulations already in place.
1. training is getting longer and longer (not shorter)
2. midlevel creep is leading many to consider further sub-specialization (more training)
3. examinations every 10 years and more frequent for many physicians anyways
4. with more private groups being bought by hospitals, the monitoring of turn-around-time, results of care, doctor ratings by subjective criterias is increasing
5. when I was in surgery rotation, all i heard about was how many surgeons talked **** about each other's results and so forth. let's just say you don't want to be in a den where things mess up. You'll hear from someone that's for sure.
6. there will always be cowboys/girls but the method you are suggesting is more likely to harm us than help
7. The older physicians (nearing their 70s) are some of the nicest and wisest I've come across and have great teaching potential. They have less work hours and are way more refreshing to hear from and work with. I would hate if an iron fist came along demanding for their retirement.
8. age is just a number. Ability and skills don't necessarily correlate to it within a specific parameter (that range has a subjective value that perhaps can be appointed on the masses based on averages but let's think about it on an individual person's basis; afterall, doctors are highly skilled and sought after individuals).

 

[OrthoTraumaMD]

smart phones that unanimously improve the lives of everyone in a health oriented job.

Lol no. If I never used a smartphone again it would be too soon. It’s a tool for enslaving physicians and making sure they are “always available” regardless of their personal life.

 

[sah]

Here is a little more information

Many aging doctors undergo memory tests to keep patients safe

A group of researchers at Yale University presented results from a three-year program where doctors over the age of 70 were tested for memory skills.

abcnews.go.com