How Do You Deal With Aging Surgeons?
Assess cognitive and physical skills in the twilight of their careers.
Y
ou can't force older sur-
geons into retirement, but
it's important to find out if
they can still operate safely. Here
at Stanford Health Care (SHC), the
medical staff implemented a Late
Career Practitioner Policy, which
uses focused physical exams and
robust peer reviews to screen
physicians. Our goal was to stay
out in front of the aging physician
issue with a policy that's evidence-
based, practical and as respectful
as possible. Here are its key ele-
ments.
• Application. After turning 75,
all physicians practicing at SHC
must undergo physicial exams and
peer reviews every 2 years. Age 75
was chosen somewhat arbitrarily, but the choice was guided by data
that show the rate of decline of cognitive functions starts gradually as
early as age 35 or 40 until about age 70 or 75, when deterioration
begins to increase at a faster pace. This policy does not violate the
Age Discrimination in Employment Act, which protects workers 40
years of age and older from being denied employment due to advanc-
ing age, as physicians practicing at SHC are not hospital employees.
• Peer reviews. Our policy initially included a cognitive screen, but
we critically reexamined that element when some physicians voiced
2 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 8
Staffing
Ann Weinacker, MD
• GRAY AREA Plenty of older surgeons are top performers,
but it's important to identify the docs who are on the decline.