Older doctors could soon be forced to have regular health check-ups in order to continue working after the Medical Board of Australia found complaints against practitioners aged over 70 were increasing.
The board has begun a consultation process with doctors on the proposed change, with chair Dr Anne Tonkin saying the measures were aimed at ensuring patient safety.
“As we all age, all of us get health issues, and doctors get them just as much as anyone else does,” Dr Tonkin said.
“Occasionally the health issue makes it difficult for the doctor to look after their patients safely, so we have a patient safety issue. And we are looking to deal with that issue.”
Dr Tonkin said the medical board’s data showed doctors over the age of 70 were 81 per cent more likely to have a complaint made against them.
The rate of complaints against older doctors is increasing too, up from 36.2 complaints per 1000 doctors in the age group in 2015, to 69.5 last year.
Doctors over 80 were 180 per cent more likely to have complaints made against them, with the board 1.7 times more likely to take action.
A consultation paper released this week canvassed three options.
The first was to do nothing, which Dr Tonkin said was unacceptable.
“We have a moral imperative to do something,” she said.
The second option was a detailed health assessment of the fitness of a doctor to practice once they turned 70.
Those assessments would be conducted by specialist health professionals.
“I think it’s more than is necessary to deal with the problem,” Dr Tonkin said.
The third option, and the one the board is recommending, was a general health check-up by the doctor’s own GP.
It would need to happen every three years for doctors in their 70s, increasing to annually once they turned 80.
Dr Tonkin said that option could be a “win-win”.
“If a doctor goes along for a health check, when they haven’t been doing that up until now, they might have an early diagnosis of something that they can then deal with and go on practising for longer,” she said.
“So this is possibly something that will benefit the doctor as well as benefitting patients.”
‘I don’t think age is a good criterion’
The idea of mandatory health checks based solely on age, rather than on competency, has some older doctors concerned.
“Seventy is quite an arbitrary number to start off with,” said 72-year-old Sydney-based orthopaedic surgeon Dr Andreas Loefler.
“Certain illnesses come much earlier, some people get say Parkinson’s in their 50s.”
Dr Loefler has previously worked as the chair of professional standards within the Australian Orthopaedic Association.
He said that in his tenure it was mostly younger surgeons he had to deal with.
“We actually need to deal with surgeons on the whole, or maybe doctors on the whole, in a different way. And I don’t think that age is a good criterion.
“I’m not at all objecting to having a regular health check. What I’m asking is, what conditions are we going to use? What measures are we going to use to let somebody operate or not operate?”
When it comes to the physical demands of orthopaedic surgeries, which require both strength and precision, Dr Loefler said he was still up to the job.
“I have learned over the years to do surgery neater. And I’ve learned over the years to be more ergonomic in what I do. But I personally have no weakness. I still do long operations, I still do on-call for spinal surgery. And I still do big operations.”
’70 is the new 50′
Adelaide GP Dr Rod Pearce, who has just turned 70, agreed that age was not the main concern for doctors, but competency.
“Generally, physicians don’t have a concern about being accountable, that their peers and the public are safe,” he said.
“It’s when it comes as an age-related thing rather than a competence-related thing or an incident that we have some concerns. And 70 is the new 50.
“We think it should be based on some sort of competency need, rather than age related.”
The Australian Medical Association president Professor Steve Robson said the right balance had to be found between protecting patients and “unlawful and unjustified aged-based discrimination”.
“Health checks must be evidence-based, fair and consistent and not drive or force doctors into earlier retirement,” he said.
“If the medical board introduces health checks for late-career doctors the focus must be on supporting doctors.”
Prof. Robson said older doctors also had important roles to play in leadership and training for younger colleagues.
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All doctors regardless of age need some sort of competency test every few years not just cognative testing but also knowledge. I’m now going to say it, especially foreign doctors in public hospitals. Two members of my family, both had ankle injuries months apart, and both were sent home saying it was just a sprain – both had fractured their ankles, one quite badly. Luckily GP sent for xray and then appointment with orthopaedic surgeon (3 months later) as it was still a healing fracture. So I can only imagine how many incompetent doctors would be found at GP clinics and hospitals.