Recent data from the Pew Research Center reports that retirement rates declined during the Great Recession in 2010. This continued throughout the decade that followed, with a small increase in retirement rates during and shortly after the pandemic. This has contributed to a trend that started in 1997, when older adults chose to continue working instead of retiring. Pew researchers also found that government agencies expect this trend to continue. The United State Bureau of Labor Statistics projects that 40% of those aged 65 to 69 will be part of our nation’s workforce in 2030.
There is certainly value to having more experienced members within the workforce, especially in specialty fields where experience can prove invaluable. When it comes to the healthcare industry, the benefits of an experienced, older workforce are compounded by the fact that fewer new physicians are joining the medical community. The American Medical Association (AMA) has stated it expects the nation will experience a 40,000-physician shortage by 2034. The AMA also estimates that almost one-third of the currently practicing physician workforce is comprised of seniors. Although this segment of the physician population provides benefits, questions arise about when an individual is too old to provide quality care to their patients.
Part of the issue with determining how old is too old to continue practice are the variables that come with aging. Some aging individuals remain healthy and vibrant, while others may experience a rapid decline in cognitive and/or physical health. As such, it is important to take functional age and the individual’s true ability to practice medicine into account during these discussions. In some areas of care, rapid reaction time and precision dexterity is a required element of delivering therapy, whereas in other areas, experience and communication is sufficient. Medical professionals would likely argue a physician should cease practice when physical or mental hurdles interfere with their ability to provide quality care.
Physicians should have different roles in the health care system at different ages
The demands, stress and risk of injury profiles differ among types of medical practitioners. A thoracic surgeon has a much different demand, stress and risk profile than a psychiatrist or rehabilitative medicine physician. Physicians who face acute life-threatening situations, such as surgeons, interventional radiologists, interventional neurologists, anesthesiologists, obstetricians and critical care physicians, need to rapidly assess a patient’s deteriorating situation and react immediately in the moment. In other areas of medicine, reacting to the immediacy of the situation is generally less important than experience, such as with pediatricians and dermatologists.
There is no one-size-fits-all rule for the aging physician. The importance of quick reaction time, stressful hours and high-risk procedures places an importance on youth; in matters involving experience and longitudinal primary care, age has value. Much like aging drivers, using the car to go to the grocery store is one thing, while driving through a major city during rush hour is another.
There is also a special role for the retired physician who can volunteer hours to assist in medical outreach programs to provide primary care for the poor and disadvantaged populations. They have the time and knowledge to make a difference in the lives of many people. As many lives can be saved in the clinic as in the operating room – it just takes longer.
What safeguards are in place for keeping patients safe from aging physicians?
Safeguards are currently in place to help better ensure those who experience a cognitive or physical decline do not continue to practice medicine. Each state tasks a medical board with ensuring the safety of patients through a licensing system. This often includes requirements to attend continuing medical education (CME) courses to stay up to date on the latest practices and innovations, as well as the ability of peers to report their counterparts if they notice signs of decline in their fellow healthcare workers.
Some medical facilities have also attempted to include their own layer of protection, requiring age-related or cognitive testing to help make sure their older physicians provide high quality care. But not all physicians agree with these methods; some have fought back and filed lawsuits to fight these efforts, alleging the practice is a form of age discrimination. Practicing physicians argue that any type of monitoring should not focus on age, but instead provide uniform screening. Most importantly, screening needs to be relevant to the stress profile of the specialty. The screening for a surgeon to maintain operating room privileges should differ from that used for a general practitioner providing primary care.
Do these safeguards work?
Even physicians point out that they do a poor job policing themselves. It is not always easy to report a co-worker. This can result in large hospitals and other facilities allowing their patients to receive treatment from physicians who are no longer physically or mentally able to provide quality care.
While lawmakers could put in place a federally-mandated retirement age for medical professionals, legislative solutions cannot fix this problem: we have increased demand for physicians of all types, and automatically removing older physicians who have a lot to offer in primary care and volunteer clinics from the healthcare workforce is a mistake. Certain professions that involve high risk precision work may find that skill reassessments are necessary and, in such situations, medical boards and are in the best position to provide accountability for their members and to put limits on physicians where limits should be placed.