Aging Doctors Face Greater Scrutiny

By Sandra G. Boodman
Originally published on December 10, 2012
Kaiser Health News in collaboration with The Washington Post

A distinguished vascular specialist in his 80s performs surgery, then goes on vacation, forgetting he has patients in the hospital; one subsequently dies because no doctor was overseeing his care. An internist who suffered a stroke gets lost going from one exam room to another in his own office. A beloved general surgeon with Alzheimer's disease continues to assist in operations because hospital officials don't have the heart to tell him to retire.

These real-life examples, provided by an expert who evaluates impaired physicians, exemplify an emotionally charged issue that is attracting the attention of patient safety experts and hospital administrators: how to ensure that older doctors are competent to treat patients.

About 42 percent of the nation's 1 million physicians are older than 55 and 21 percent are older than 65, according to the American Medical Association, up from 35 percent and 18 percent, respectively, in 2006. Their ranks are expected to increase as many work past the traditional retirement age of 65, for reasons both personal and financial.

Many older doctors remain sharp, their skills up-to-date and their judgment honed by years of experience. Peter Carmel, the AMA's immediate past president, a 75-year-old pediatric neurosurgeon in New Jersey, recently wrote about "going full tilt."

Unlike commercial airline pilots, who by law must undergo regular health screenings starting at age 40 and must retire at 65 -- or FBI agents, whose mandatory retirement age is 57 -- there are no such rules for doctors. Nor are any formal evaluations required to ensure the continued competence of physicians, many of whom trained decades ago. Most states require continuing education credits to retain a medical license, but, as Ann Weinacker, chief of the medical staff at Stanford Hospital and Clinics in California, observed, "you can sleep through a session, and if you sign your name, you'll get credit."

The entire article is here.

Psychologists helping psychologists

Determining your responsibilities when you believe a colleague may have behaved unethically.

By Rebecca A. Clay
The Monitor on Psychology
October 2012, Vol 43, No. 9
Print version: page 36

If you saw another psychologist do something that appeared unethical, would you know how to respond?

Many psychologists don't, says Beth Kaplan Westbrook, PsyD, co-chair of APA's Advisory Committee on Colleague Assistance (ACCA) and a private practitioner in Portland, Ore. They may be unsure about laws in their state and how those laws interact with APA's Ethics Code. They may lack the information they need. Or they may be nervous about the liability issues that could arise, either from reporting a colleague or failing to do so.

ACCA is working to make sure psychologists are clear about how to react when a colleague needs help. In addition to creating a series of online resources, the group is urging state, provincial and territorial psychological associations (SPTAs) to create colleague assistance programs that can stop problems before they become crises.

"Health professionals aren't immune from the same problems that affect the general public," says Westbrook, citing as examples substance abuse and mental health disorders. "ACCA's main purpose is not only to help people get the treatment they need, but also to focus on prevention—to have programs in place so that psychologists can seek help or refer colleagues as problems arise."

The entire story is here.