Older physicians: testing is only part of the solution

As Doctors Age, Worries About Their Ability Grow in the New York Times reports on an emerging trouble spot in medicine. One-third of physicians are over 65 and there is no clear path to ensuring that doctors retire once they are too old to work effectively. It's a difficult problem to address because:

• There's no single test to determine whether a physician is still fit to practice
• It's difficult culturally for younger physicians to force out older colleagues. That's especially true in departments where the older physician has trained the younger ones
• There are concerns about age discrimination

The issues discussed in the article are real and need to be addressed. Still, there is a piece of the puzzle that is important but not mentioned. The article talks about physicians individually, yet more and more the practice of medicine is becoming a team endeavor. Sometimes medical errors that compromise patient safety occur because one person screws up. But, commonly an error occurs when a system breaks down or isn't well set up to begin with.Clearly doctors who are senile shouldn't practice at all. But I think it would be useful to engage in discussion about how the role of a physician should evolve over time even as certain of their faculties decline. Surely a well-organized team structure has room for an experienced physician who is not at the pinnacle of his or her powers. If we can learn how to optimize the roles of physicians on these teams it could go a long way to addressing workforce shortages and enhancing patient care.