With Americans living even longer, hospitals have begun evaluating the best methods to ensure elderly surgeons are safe and competent in the operating room. Unlike other industries, such as aviation where commercial pilots are required to retire at 65, doctors and surgeons are not obligated to put down the scalpel and leave the operating room upon reaching a certain age. Given the precision and high stakes of performing an operation, health care experts worry whether this is a good idea – especially when studies show that doctors are not accurate judges of their own abilities.
Research has unambiguously shown that cognitive and physical abilities decline with age and surgeons must possess exceptional skills in both these areas to remain effective. The consequences of a delayed reaction or a minor slip of the forceps can be the difference between a patient living or dying. Studies on the mortality rate of patients with elderly surgeons have been mixed, however, with some studies showing a higher rate of patient deaths for surgeons over the age of 60 and other studies showing a lower rate. Speaking to The New York Times, Dr. E. Patchen Dellinger, an expert on aging physicians, said that the older surgeons bring to the operating room may outweigh his or her decline in abilities. In his opinion, there “are sharp, wonderful doctors, and those who need to stop” which he estimated to be approximately 5 to 10 percent of doctors over the age of 75.
In The New York Times report, the newspaper evaluates different hospital’s approaches towards aging surgeons and the competing public health implications of each approach. In general, hospitals seem wary of a mandatory retirement age because it would push perfectly competent surgeons out of the operating room. Further, some hospitals said this policy could violate state and federal anti-discrimination laws. The American College of Surgeons recommends providing “physical, visual and neurocognitive testing for older surgeons” – but only on a voluntary basis, essentially allowing the surgeons to “police themselves.”
Health care experts say the best approach may be mandatory screening for aging surgeons each year. This would judge the surgeon on the basis of his abilities and ensure an unsafe surgeon did not continue operating because he did not realize his own declining abilities quick enough. Several hospitals across the country have already adopted mandatory screening, including the University of Virginia Health System and Temple University Hospital, and many more hospitals are expected to soon follow their lead.
