Should you ditch your old doctor?

My dentist retired three years ago and my doctor has already cut back to three days a week. The task of finding trusted new health professionals can be daunting, and there is the nagging feeling you may never develop the same rapport.

But – they are entitled to retire, and sometimes they should retire.

Airline pilots have to retire at 65, High Court judges must retire at 70, drivers are re-tested annually in some states after they turn 75. Should there be a mandatory retirement age for doctors?

A new Australian study, thought to be the largest of its kind in the world, makes a strong argument for doctors to be assessed from the age of 70. And the Australian Medical Board is already putting the framework in place to “improve public safety and better identify and manage risk in the Australian healthcare setting”.

The study, led by Melbourne University lawyer and epidemiologist Laura Thomas and published in the Journal of Patient Safety and Risk Management, looked at complaints made against all doctors across Australia over a four-year period.

Senior author Associate Professor Marie Bismark said the study found that almost 87 per cent of doctors over the age of 65 had not been subject to complaints. However, when the numbers were analysed further, they told a different story, she said.

Many older doctors worked part-time and when total hours were considered, 37 per cent more complaints were levelled against them than against younger doctors, she explained to the Australian Financial Review.

“Our results suggest that patient care may be affected by changes in doctors’ cognitive and physical health resulting in notifications [complaints] to the medical regulator,” she said, explaining that the highest rate of complaints involved older GPs and psychiatrists and  most commonly related to “physical and cognitive impairment”.

“Some of these doctors have little awareness they are out of step with their peers,” said Professor Bismark, of Melbourne University’s Faculty of Medicine, Dentistry and Health Sciences, “… particularly with prescribing practices, supply of medication, management processes, record keeping and report writing. They are not on par with their younger colleagues.”

Most complaints involved older male doctors and centred on their failure to keep abreast of new drugs or changes in protocols. Disruptive behaviour, such as bullying, harassment and discrimination, was also a recurring theme.

While AMA Federal President Michael Gannon Alex Ellinghausen said doctors valued the right to continue practising past normal retirement age, the study authors suggested that ongoing professional assessment, education and support were needed.

So do you stick with an older doctor with decades of experience or find a younger doctor who may be more in touch with new technology and recent developments?

The Medical Board of Australia announced late last year that it had developed a new Professional Performance Framework – yet to be implemented – that would identify practitioners at risk of poor performance. It would require doctors who provide clinical care to have peer review and health checks at the age of 70 and then every three years.

The board said in a statement: “There is a lot of work to be done before the Professional Performance Framework is implemented. While many of the elements are in place already or only require fine-tuning, others will require more substantial work. The Board is committed to working in partnership with the medical profession and others in the health sector to implement the Professional Performance Framework.”

The five pillars of the Professional Performance Framework are:

  • strengthened continuing professional development
  • active assurance of safe practice
  • strengthened assessment and management of medical practitioners with multiple substantiated complaints
  • guidance to support practitioners
  • collaborations to foster a culture that is focused on patient safety and also encourages doctors to take care of their own health and well-being.

Have you had experience of age-related issues with a health professional? Do you support the Medical Board’s moves?

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Written by Janelle Ward

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