Are younger doctors smarter than older doctors

Doctor in old age: when is it time for retirement?

There are too few doctors and their average age is high. Soon we could be dependent on the cooperation of doctors of retirement age.

Prof. Dr. med. Serban-Dan Costa, University Women's Clinic Magdeburg

At the end of 2015, Joel M. Kupfer dealt with the question of when a doctor should give up his profession in the Journal of the American Medical Association (JAMA) under the heading "The Graying of US Physicians" (JAMA. 2015 Dec 28: 1–2) . He points to the demographic trend in the US, where 26 percent of licensed doctors are over 60 years of age and this percentage is rising steadily. The American Medical Association wants to develop guidelines or criteria to evaluate the physical and mental health of doctors as well as their cognitive and clinical performance at regular time intervals.

In a review from 2005, Choudry et al. show that a connection between older doctors and the lower quality of their work was demonstrable in more than half of the 62 publications analyzed. The authors found that, with increasing age, doctors were either unaware of or unwilling to accept the results of large randomized trials; In addition, they were less inclined than younger colleagues to implement new standards in diagnostics, screening, prevention and therapy (Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med. 2005; 142 (4): 260-73).

The efforts to evaluate medical services and competence in a standardized way and to draw conclusions from them are not new. Since there are numerous ways of collecting data today, it seems feasible to use such data collection to record the quality of medical work. One result of such a survey could be the withdrawal of the license for doctors who want to continue working after a certain age. It is also conceivable to carry out such evaluations regardless of age, which would possibly be fairer and avoid “age discrimination”.

In this country there is an age limit for medical work for salaried doctors - 65 to 67 years, depending on the current age - although there may be reasons to question this rigid definition. At the moment there is a lack of doctors everywhere; In addition, there is an increasing aging of working doctors. Age limits that are too strict should not endanger patient safety. It would be useful to determine when a doctor is too old and no longer has the necessary cognitive and neuromotor skills to practice good medicine and be useful to patients. But how is that supposed to happen? How should the more important “biological” instead of the “chronological” age be recorded?

These questions are a strong reminder of the repeated demand for a regular repetition of the driver's license test. . . well, in the elderly. Questions that are asked every time an 80-year-old “loses control of his vehicle” and causes an accident. But when are you older? There is no age from which it is scientifically proven that a person is no longer allowed to drive a car because it poses a danger to the general public. There is also no good data on how many doctors over the age of 70 actually want to continue working. It should also make a difference whether a 75-year-old prescribes acetaminophen or whether he is planning to have his next heart transplant.

Surely there are doctors who treat patients well into old age. These are mostly private patients or self-payers, so that the question of KV approval is not in the foreground. Doctors who previously worked in their own practice also occasionally continue to work. Patients decide for themselves whether they want to be examined and treated by an older doctor. And that's a good thing, you need so much trust in the judgment of patients.

All doctors - old and young - should continuously receive further training and not rely on their experience alone. Medical progress is a fact, and a doctor who does not know it and does not integrate it into his work can endanger human life. A regular review of the current state of knowledge of doctors must not stop at the "age wisdom" - that would be misunderstood consideration, a danger for patients. Older doctors willing to keep working are a win for patients. We should be happy and grateful if they want to keep going. But “a little pressure” does no harm to our valued, elderly colleagues, and I cannot imagine that they would object to it.