Heaping more tests and paperwork on older doctors is not a good way to mitigate risk, the AMA says
Heaping more tests and paperwork on older doctors is not a good way to mitigate the danger that some ageing doctors might pose to patients, the AMA says.
With 80% more doctors now aged over 65, compared with 13 year ago, Australia’s medical profession is starting to show grey hairs. And research shows more and more doctors are putting off retirement.
It’s a trend that’s causing concern in other countries, also. Writing in JAMA Surgery this month, US researchers argue the medical profession should consider mandatory performance evaluations, based on age, before regulators impose more “draconian measures”.
“Physicians understandably take great pride in the knowledge and skills that they acquire over their career, and see their role as physicians as a treasured element of their identity,” the researchers wrote.
“Yet the public expects, and fundamental tenants of medical professionalism require, that medicine take more vigorous steps to ensure that physicians practice safely, at any age.”
The Medical Board of Australia lists ageing as one of the strongest risk factors for regulatory action. Yet many doctors can sail into their 80s without being formally assessed for competency.
AMA President Dr Michael Gannon said the association would push back against proposals to add to “burdensome bureaucracy” on doctors – such as forcing older doctors to re-sit fellowship examinations – when there was no evidence that such measures protected patients.
“What we won’t do is simply sign off on more bureaucracy that doesn’t actually achieve anything,” Dr Gannon said.
“There are doctors working into their late 70s who are still performing at a very high level,” he said. “And there are doctors in their 30s who might represent a risk to patients. So I think that arbitrary age cut-offs aren’t particularly helpful.”
Dr Gannon said the existing continuing medical education system could be made more robust to ensure high standards were maintained.
“So doctors would need to do more than just tick that they are staying up-to-date with their reading,” he said. “They would need to do more than just sign up to a conference.”
Dr Leon Piterman, Professor of General Practice at Monash University, said the workforce shortage in rural areas sometimes compelled older doctors to stay in their jobs longer, despite a declining skill level.
Doctors were often reluctant to report loss of competency in their older peers, he said. And older doctors could lack insight into their own condition.
A peer-review assessment process organised through the medical colleges should be considered, Dr Leon Piterman said.
JAMA Surgery 2017, 19 July
