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Our Aging Medical Community

I read an article today that discussed a subject that I frankly hadn’t considered before, and I’m sure many other people haven’t either.  But, it’s good that other some have started looking into it.  That subject is the problem of our aging medical community — or, more particularly, doctors.  According to the American Medical Association, about 42% of the country’s one million physicians are 55 years old or older, and 21% of them are over the age of 65.  This number has been increasing in recent years, as people in the general workforce tend to be working longer.

Now, just because a physician may be advancing in years, that doesn’t automatically mean that his knowledge or skills have decreased.  Many older doctors work hard to keep current on the latest developments in the field, and are just as capable as they have always been.  But according to William Norcross, the founding director of PACE (Physician and Clinical Assessment — a program at the University of California at San Diego that routinely performs intensive competency evaluations of physicians who are referred by state medical boards or hospitals), there may be as many as 8,000 practicing physicians around the country who have full-blown dementia.

Commercial airline pilots must undergo regular health screenings once they reach 40 years of age, and must retire by the time they are 65.  FBI agents have a mandatory retirement age of 57.  But doctors are not subjected to such scrutiny.  Most states require that doctors attend a certain number of continuing education events in order to renew their licenses, but it’s not all that hard to show up and sign a paper, and then sit in the back of the room and sleep through the session.  And, while you might think that co-workers might report a colleague who appears to be slipping, it’s perhaps not surprising that many will instead overlook observed errors, and even quietly correct orders or use other methods to cover up difficulties.

This is changing, however.  A growing number of hospitals and state and professional organizations are recognizing that there is a problem, and taking steps to deal with it.  Some have started requiring doctors over the age of 70 to take part in regular physical and cognitive exams as a condition for renewing their privileges.  Others argue that such scrutiny is unnecessary, and possibly even detrimental.  They state that this is something that should be considered on an individual basis, and that mandatory age-related testing is just not appropriate.

Here are some actual examples, that illustrate the nature of the problem that our country is facing, if it is not addressed.  One doctor went on vacation, but forgot to make arrangements to have other doctors take care of his patients while he was gone — with one of those patients subsequently dying.  One doctor got lost going from exam room to exam room in his own office.  And a beloved surgeon with Alzheimer’s disease continues to conduct operations because his colleagues don’t have the heart to tell him he needs to retire.

Then there is the case of rheumatologist Ephraim Engelman, who will turn 102 in March.  He says he plans never to quit.  He continues to drive himself from his home to his offices at a large university campus, three days a week.  He sees about eight long-term patients a week, and spends most of his time on administrative activities.  He continues to direct the Rosalind Russell Medical Research Center for Arthritis at the University of California at San Francisco, and has since it was founded in 1979.  He also plays the violin once a week with a chamber music group.  Engelman has stated that he is not opposed to evaluations of older physicians, and has asked his colleagues to let him know if he starts to show signs of losing function.  But he also says that he will continue to practice medicine in some fashion as long as he possibly can.

And I hope he is able to do so for a long time to come.

(Read the original article here.)

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