14
votes
When is it time for an older doctor to hang up their stethoscope? We owe it to their patients to get it right.
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- Authors
- Ranjana Srivastava
- Published
- Oct 8 2024
- Word count
- 995 words
I think we start doing these checks on fitness way too late for any person. If the age of retirement is 67, then we should be doing these checks from 60 so that we can start to assess when retirement should happen.
But this also needs to go with the territory of med schools being more accepting of incoming med students, and treating residents/freshman doctors with more respect, no one should have to work more than an 8-hour shift, least of all a doctor who has people's lives on the line. Practicing anything sleep-deprived is like practicing drunk or high, and that's not good for a car, and it's not good for life-saving.
The entirety of the doctor pipeline needs to be updated, and hopefully it will in the coming years. From this article, a good first start would be to lower the age when fitness checks start, and to require all doctors to have a GP, as soon as they are out of med school. Chronic illness and disability can hit at any time, there is no specific age to become disabled.
For anyone who's unaware, the modern medical residency system (post med-school specialty training, which is functionally mandatory to practice in the US, in which residents work 80-hour weeks for something like a quarter the pay that an attending physician would earn for the same work) was established by a certain William Halstead, who was addicted to cocaine, and therefore presumably thought the workload was reasonable because, y'know, he was high on cocaine.
The system is essentially all downside for everyone except the hospital systems which benefit from a 75% markdown on physician labor, and it's long past time we threw it all out and started over (ideally with less input from stimulant drug abusers).
A mandate is an interesting idea, and I wonder what the pushback would be.
I'm one of the go-to providers in my region for neuropsychological evaluation of physicians, and it takes a lot of care to facilitate a graceful exit from doctoring when that needs to happen. Cognition would be one of my main concerns at that age as far as fitness to practice is concerned. Screening measures performed by an occupational health provider are too coarse to provide the detail needed for the question, so I hope they involve my neuropsychologist colleagues in the process as needed.