Late Career Physicians in Practice
A recent study published in the Annals of Internal Medicine examines how healthcare organizations (HCOs) are implementing policies for late-career physicians (LCPs) – those continuing to practice beyond ages 65-75. The research, led by Dr. Andrew A. White from the University of Washington School of Medicine, involved interviews with 21 physician leaders across 18 HCOs to understand key features and perspectives on these policies.
The study found significant variation in late career physician policy details, including required assessments, funding sources, follow-up processes for positive screening results, and decision-making protocols. However, several common elements emerged:
- Mandatory universal screening around age 70
- A two-step approach of initial screening followed by in-depth assessment if needed
- Patient safety as the primary motivation
Many policies emphasized institutional discretion in interpreting and acting on test results. However, they often lacked clear language about appeals processes or other procedural safeguards for physicians.
Overall, leaders expressed satisfaction with their late career physician policies. An interesting finding was the occurrence of preemptive retirements as physicians approached the designated screening age.
The researchers concluded that while current policies aim to protect patient safety, there are opportunities to better balance this goal with the interests of experienced physicians.
Commentary by YourDailyFit columnist Alice Winters:
This study on late-career physician policies sheds light on a complex and sensitive issue in healthcare management. As our medical workforce ages, striking the right balance between leveraging valuable experience and ensuring patient safety becomes increasingly crucial.
The variation in policy details across organizations is both concerning and unsurprising. It reflects the lack of standardized best practices in this area, potentially leading to inconsistent treatment of late career physicians across the healthcare landscape. This disparity could have implications for physician mobility and career longevity.
The universal screening approach around age 70 raises questions about age discrimination. While age can correlate with declining cognitive and physical abilities, it’s a crude proxy at best. A more nuanced, performance-based approach might be more equitable and effective.
The reported preemptive retirements are particularly troubling. If experienced physicians are opting out of practice to avoid screening, we may be losing valuable expertise prematurely. This unintended consequence could exacerbate physician shortages and reduce mentorship opportunities for younger doctors.
The lack of clear appeals processes in many policies is a glaring oversight. Without robust procedural protections, these policies risk being perceived as punitive rather than supportive, potentially fostering resentment and resistance among senior staff.
Moving forward, healthcare organizations should consider:
- Developing more standardized, evidence-based screening protocols
- Implementing continuous performance monitoring rather than age-triggered assessments
- Creating clearer appeal and support mechanisms for physicians
- Offering flexible work arrangements to retain experienced physicians
- Focusing on supportive interventions and skill development rather than purely evaluative measures
Ultimately, the goal should be to create an environment where late career physicians feel valued and supported, while still prioritizing patient safety. This approach could help retain crucial expertise, promote intergenerational knowledge transfer, and ensure the highest standards of care across all age groups in the medical profession.
