A little-noticed report from the most recent American Medical Association annual confab called for creating guidelines to test aging physicians for competency. The group wants to “head off a call for mandatory retirement ages or imposition of guidelines by others.”
It's a growing concern now that 26% of active physicians in the U.S.—about a quarter of a million docs—are over 60. Fears that they will soon go running for the exits and create a physician shortage are competing with fears that they will stick around forever and create a quality performance gap.
The report largely accepted the idea that physician skills deteriorate with age, according to an article that appeared on the AMA Wire. Older physicians may suffer from a decreased working memory, declining visual acuity and slower mental operations, the report said. “Research also shows that older physicians are less likely to acquire new knowledge over time, (and) older primary-care physicians are less likely to incorporate new treatment strategies into their practices,” the report stated.
Not so fast, argues Dr. Joel Kupfer, a professor at the University of Illinois College of Medicine in Peoria. In a viewpoint that reviewed existing studies in the current Journal of the American Medical Association, he said there's not much evidence backing claims that older physicians are more likely to see their skills deteriorate or avoid learning the latest techniques.
“The research in this area is inconclusive, and physician age may have less influence on clinical performance than previously thought,” he wrote. “Hours worked, number of patients seen per week, availability of specialists and the functionality of the electronic health record” are increasing stress and may play a much larger role in influencing clinical performance.
By all means, create a national standard for testing physician competence, he said. But it should “be applied to all physicians, regardless of age, wherever and whenever they work.”
