An article in the New York Times draws attention to the problem of unrecognized cognitive impairment in some aging doctors.
And some experts warn that there are too few safeguards to protect patients against those who should no longer be practicing. “My guess is that John Q. Public thinks there is some fail-safe mechanism to protect him from incompetent physicians,” Dr. Norcross said. “There is not.”
Often the mechanism does not kick in until a state medical board has found it necessary to discipline a physician. A 2005 study found that the rate of disciplinary action was 6.6 percent for doctors out of medical school 40 years, compared with 1.3 percent for those out only 10 years.
In 2006, a study found that in complicated operations, patients’ mortality rates were higher when the surgeon was 60 or older, though there was no difference between younger and older doctors in routine operations.
Since our brains do not all deteriorate at the same rate (yes, your brain is deteriorating) it would help to know which physicians in their 60s are still at or at least near the top of their game. The ones with high blood pressure, high cholesterol, too much fat, insulin resistance, a history of alcohol or drug abuse, and other sources of wear and tear are going to be in worse shape on average. That holds for the rest of us as well.
What I'd like to see: Medical expert systems that check diagnoses as a way to spot deteriorating diagnostic skills. If such systems could reach the same conclusions as the best doctors in a specialty at a very high rate then expert systems could be used for quality control. An older doctor who too often reached different conclusions than his shadowing expert system could be required to undergo testing of medical competency.
|Share |||Randall Parker, 2011 January 24 11:11 PM Policy Medical|