Hospitals require cognitive testing for some older doctors as workforce ages

Hospitals and health systems are increasingly confronting the question of how to assess older physicians’ fitness to practice, with some instituting late-career screening programs that require cognitive testing for clinicians above a certain age while many doctors and organizations resist such mandates.

The physician workforce is aging: in 2005 just over 11 percent of doctors seeing patients were 65 or older, and last year the proportion reached 22.4 percent, nearly 203,000 older practitioners, the American Medical Association said. Researchers have documented “a gradual decline in physicians’ cognitive abilities starting in their mid-60s,” according to Dr.

Thomas Gallagher of the University of Washington, although scores vary greatly among individuals. Some hospitals have created formal programs. Sinai Hospital in Baltimore began a screening program for surgeons over 75 in 2015 and has performed comprehensive assessments on about 30 surgeons from around the country; the testing can find mild cognitive impairment and lead to role changes, as in one case where a 78-year-old surgical oncologist was removed from the operating room but continued clinic work.

UVA Health started a program in 2011 and has screened about 200 practitioners, with results prompting significant changes in practice or privileges in four cases. Stanford Health Care and Penn Medicine have similar programs.

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