Age catches up with all of us, but in medicine, it’s catching up with some more than others. In 2015, the number of practicing physicians older than 55 (a.k.a. Aging Physicians) topped 30 percent. In some specialties, aging is even more prevalent. In 2013, more than half of neurologists, orthopedic surgeons, cardiologists, psychiatrists, oncologists, pulmonologists, and immunologists/allergists were older than 55.
We are hearing from CMOs across the country that “aging physicians” are a primary concern. Following is Greeley’s “top ten list” of relatable issue area questions we have been asked to help address. What was perhaps most prevalent was the belief that the challenges related to the aging physician population was unique to particular facilities. We decided to share this to let hospitals know that they are not alone in these challenges and considerations. In fact, if you have not run into most, if not all, of these issues in your facility already, you are a finite exception.
Top 10 “Aging Physicians Issues” + Related Questions
- Do we (or should we) treat physicians differently based on their age? If so, how?
- What is an appropriate standard of age-based criteria to gauge age-related decline?
- How do you make objective and respectful what can be a very subjective and intrusive assessment?
- Should there be limitations on what an aging physician is allowed to do?
- Should there be accommodations made for specific activities that would allow aging physicians to continue to practice?
- How do you stave off revolt if aging physicians are allowed a pass on ER duties…or if they are not?
- Is there a standard by which eligibility restrictions can be classified (physical demands, visual acuity, limited dexterity, technical aptitude, etc.)?
- What should be included in fitness for duty assessments? What are criteria and thresholds?
3. Peer Review
- Is there precedent for changing the criteria and parameters for peer review based on the age of the practitioner?
- What does the radar screen look like? How does the scope of peer review change? What are the appropriate standards of measurement?
- What are acceptable tolerances?
4. External Peer Review
- How do we build external peer review into our process so that it is not singling anyone out? Or is it only appropriate if/when there are stated concerns?
- Is there precedent for queueing an external peer review requirement on reappointment after a certain birthday?
- What areas do we need to “tighten up” so that the subjective decision-making burden is lightened for our Credentials Committee, Medical Executive Committee, Peer Review Committee, and medical staff services department?
- The “ER Call” question again… How can discretionary exceptions be made without political fall-out?
- Are we at risk of challenges based upon age discrimination?
- Are we setting the bar too high? How can we craft policies and procedures that balance the rights of aging physicians with the duty to protect patient care?
- How do we manage risk associated with aging physicians, while managing the rights of those same aging physicians? Is this forcing a harder look at our tolerance for risk? Is our handling of aging physicians in alignment with our risk tolerance?
8. Employed Physicians, Physician-Hospital Alignment, Physician Engagement
- How do we set tone and expectations when onboarding a physician group or integrating a practice that includes aging physicians?
9. Conflict Resolution
- Are there different “rules of engagement” when dealing with aging physicians? Are there conflict resolution methods that are more appropriate and effective in resolving disputes and organizational challenges?
10. Training & Education of Physician Leaders/Approaches to Change
- What is the best way to communicate paradigm shifts, organizational change, and new ideas to aging physicians, as well as hospital executives and physician leaders about aging physicians? And how do physician leaders then gain buy-in?
Ready to explore answers to these questions (and more) and start the conversation about “aging physicians” in your organization? Register for our upcoming Free Webinar Aging Physicians: Practical Answers to CMOs’ Questions. Or schedule a call with Greeley CMO Rick Sheff.
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