Taking a Commonsense Approach to Aging Practitioners

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In this article, Greeley’s Chief Credentialing Officer Sally Pelletier, CPMSM, CPCS, offers advice and guidance for physician groups, hospitals, and systems about aging policies for practitioners. 

Aging Baby Boomers may be taking flight out of the general workforce, but in healthcare older practitioners are maintaining strong numbers. In fact, physicians age 65 and older have more than quadrupled since 1975. Senior physicians now comprise 23 percent of the national physician population. According to a 2015 American Medical Association survey, 43 percent of practicing physicians who actively provide direct patient care are 55 and older.

“With so many practitioners practicing well into their 70s, 80s and even 90s, hospitals and medical staffs alike have growing concerns over age-related performance issues,” says Sally Pelletier, CPMSM, CPCS, advisory consultant and chief credentialing officer with The Greeley Company. Research tells us the obvious, says Pelletier. “Human performance changes with age due to cognitive and physical decline.”

Indeed, changes appear to happen between ages 65 and 75. As people grow older their reactivity, vision, cognitive performance, stamina, and ability to respond after sleep deprivation all change. “And, while it might take them longer to decline, practitioners are no exception,” says Pelletier.

Why Aging Policies Must Become a Priority

As a result, hospitals and medical groups are challenged with how to maintain patient safety while being fair to older practitioners who aren’t ready to retire. Anecdotal evidence suggests that peer review early warning systems often fail to detect performance issues due to bias and difficulty measuring clear criteria. What’s more, negligent credentialing is also cause for increasing concern. “This is why it is critical to have an aging practitioner policy,” says Pelletier.

Both regulatory and accrediting agencies require that a practitioner’s mental and physical health be evaluated as a part of his or her ability to perform requested clinical privileges. “It is incumbent upon hospitals to ensure they have policies that enable them to provide quality patient care while protecting both the patient and the practitioner,” says Pelletier.

That same accountability is also assigned to the organized medical staff by the governing board. Thus, the medical staff has an obligation to appropriately monitor the capabilities, competencies and health status for all privileges granted for all practitioners. This, of course, is done in accordance with the established medical staff bylaws, policies and procedures related directly to privileging.

All of this bolsters the point that having an aging policy is normal and necessary, says Pelletier. “An aging policy naturally flows from these regulations and responsibilities that make sure practitioners are competent.” According to Pelletier, many high achieving organizations are putting aging policies in place. “The Greeley Company regularly provides guidance on how to create an effective policy,” says Pelletier. Sometimes the impetus comes from medical services professionals looking to adopt industry best practices, with a healthy dose of concern that it will be a political challenge to develop a policy and get it approved.

Greeley consultants also see the aging practitioner issue bubble up during client engagements aimed at improving physician-hospital alignment. Greeley advocates that it is better to establish a policy than to make subjective decisions that feed into a politically charged environment…

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