The debate has raged for years: At what point does a doctor’s age begin to affect his ability to practice medicine efficiently?
Cognitive decline and skill decline, especially among surgeons, raises concerns about patient safety.
Evidence for a link between age and efficiency
A case study was published in Clinical Ethics Summarizes the problem posed by the aging group of physicians. The 80-year-old pulmonologist began showing symptoms of poor short-term memory. After he had low scores on mental status tests, he began taking donepezil to improve mental function.
But 6 months later, after his mental status scores plummeted, he still refused to withdraw, despite a presumed diagnosis of dementia.
The authors cited various reviews and analyzes indicating that the above case is not an exception. One study found that while non-analytical knowledge appears to remain constant with age, analytical processing tends to decline. Also, a review concluded that physician performance declines with age.
Some doctors retain all their cognitive abilities despite their age
However, other studies have found that this is not a black and white case. One study evaluated the cognitive performance of a group of 1,002 physicians and 581 non-physicians. The researchers found that each group tended to show cognitive impairment as they got older, but there was a much greater variance among clinicians than the other group. In fact, some doctors have retained all of their cognitive abilities despite their age.
The authors of the clinical ethics case study note that declines in colleges occur in different ways for different people. For some, it may be a decrease in strength; For others, sight; Still others, realization. As such, doctors in certain specialties may be perfectly fine to continue their practice.
The question, then, is: How and when do we assess the capabilities of physicians as they age?
Research indicates that clinicians have “limited ability to assess their own competencies.”
Physicians also tend to be reluctant to report on their disabled colleagues, in part due to a culture that presents older adults as mentors. The authors of the clinical ethics case study concluded that cognitive examination should be applied, but the framework remains debated.