Aging doctors is a complicated subject. A doctor’s competency is their capacity to do their duties with a tolerable level of expertise and safety, which considers their mental and physical capabilities. Age-related changes can affect a clinician’s capacity to practice competently while their obligation remains constant throughout their professional careers. Vision and hearing start to deteriorate between the ages of 40 and 50. Other cognitive abilities such as verbal memory, inductive reasoning, visual-spatial ability, and others also diminish with age, with the sharpest declines occurring beyond age 65.
However, as decreases in strength, cognition, and fine motor skills differ significantly from person to person, so do the rate and magnitude of these changes. With time, the capacity for sustained attention and performance in the face of many visual, aural, or other stimuli might also decline. Implementing a mandatory retirement age in the US is impracticable and unlikely given the physician labor shortages, even in nations with plentiful resources. By requiring age-linked testing and evaluation for doctors, several US hospitals and organizations have aimed to allay worries regarding competency. These approaches, though, have prompted concerns about test validity and age discrimination.
Despite acknowledging their responsibility to safeguard the public, compelling facts indicate that when cognitive decline negatively affects medical practice, physicians frequently fail to report themselves, their colleagues, or their physician patients. Therefore, efforts to inform doctors of their ethical responsibilities and different deft ways to report themselves or others are futile.
The case centers on the problem of aging physicians in a renowned medical facility without a specific policy on the age of mandatory retirement. Dr. Smith is a reputable doctor with years of experience who has forged strong bonds with his patients throughout his career. However, several medical residents and junior colleagues are worried about Dr. Smith’s probable deterioration in cognitive function and clinical expertise. The healthcare facility must balance recognizing elderly physicians’ right to continue practicing medicine with addressing their competency.
The elderly doctor Dr. Smith, the hospital’s management, younger coworkers and junior doctors, and the patients in Dr. Smith’s care are all essential participants in this case. The part played by Dr. Smith is that of a committed medical professional who wants to keep treating his patients. To protect patient welfare and provide high-quality care, the administration must strike a balance between Dr. Smith’s commitment and knowledge. Worries about patient safety and career chances among younger colleagues and junior doctors may exist. In addition to placing a high value on receiving quality medical care, patients cherish their relationship with Dr. Smith and their trust in him.
Patients have a right to obtain competent, superior medical treatment from their doctors, assuring their well-being and safety. They have the right to ask questions regarding their credentials. Patients may suffer injury if they receive inadequate care due to an aging physician’s declining abilities. Justice dictates that doctors should not be subjected to undue dangers, regardless of age.
Aging doctors have the right to practice medicine as long as they are competent and skilled. A physician pushed into retirement but whose abilities have not diminished as they age could develop depression. Justice dictates that aging physicians receive fair treatment and are not subjected to age discrimination as long as they meet the necessary competence levels. Physicians who are getting older are responsible for evaluating their competence and deciding whether to continue practicing routinely.
Young doctors are entitled to pursue a medical profession and provide patient services. The harm is that young physicians may have fewer prospects for career advancement and employment if older physicians continue to practice despite deteriorating competence. The erosion of faith in doctors may be another negative impact. Justice demands that junior doctors be given the same opportunity to develop their careers and support the healthcare system. Young doctors are responsible for pursuing excellence and promoting healthcare services’ high caliber and reliability.
The AMA is entitled to set standards and laws to guarantee the skill of healthcare professionals. Patient care may be jeopardized if proper evaluation methods are not developed and upheld. It is also possible that this will cause AMA’s credibility to decline. The AMA should prioritize justice and public safety by ensuring that doctors are evaluated based on their qualifications. To preserve patient safety and uphold professional standards, the AMA must establish general and impartial assessments of physicians.
The institution that employs the aging doctors has the right to ensure that despite their age, the aging doctors can practice to total capacity. The harm in this is that there could be an increased occurrence of medical errors due to the physician’s advanced age. The institution that employs aging doctors is responsible for ensuring that all patients receive optimal care while ensuring all physicians, aged or young, practice in a conducive environment to thrive. Justice demands that they should be allowed to practice their profession unless given sufficient reason to limit aged physicians’ practice.
The ideals portrayed in this situation include those of patient safety, high-quality medical care, career satisfaction, allegiance, and autonomy. No matter the doctor’s age, patients must receive competent medical care. Therefore, patient safety and high-quality healthcare are essential. Dr. Smith’s professional satisfaction and commitment to his patients are also priceless because they recognize the significant relationships and expertise he contributes to his office. The ethical tension is brought on by the contradiction between the obligation to prioritize patient safety and the duty of loyalty to a respected colleague.
Aging doctors may experience problems when they doubt their abilities and wonder if they can still give their patients safe and effective care. Due to probable reductions in their clinical expertise or cognitive capacities, they can be torn between retiring or curtailing their profession. They may wonder if carrying on with their profession benefits their patients or if it is motivated by more private factors, such as financial or emotional ones. When patients learn their aging doctor has competency problems, they may encounter moral quandaries. They can be conflicted between needing to see a doctor they believe to be better qualified and being loyal to a longtime doctor. Patients may experience moral anguish due to having to make choices that affect their well-being. When they see the potential repercussions of a physician’s incompetence, coworkers and medical personnel who deal with aged doctors may feel morally distressed. They can be torn between the emotional strain and distress of confronting a coworker, raising concerns with supervisors, or fighting for patient safety.
Some of the viable alternatives that can be implemented to address the issue of aged physicians include; ensuring autonomy and informed consent of the aged physicians in decisions concerning their career, avoiding any discrimination of the aged physicians in the hospital due to their age, in terms of policies and practices implemented. There should be a balance between competency and experience; this will be done by recognizing the aged physician’s value and ensuring they maintain their competency in their practice. There should be transparent policies that are fair to address the issue of aged physicians. Shared collaboration and engagement should exist in any implemented policies based on shared values and principles.
Some of the recommendations for the issue of aged physicians include; a job redesign and workload management to better accommodate the changing needs and capabilities of the aged physicians. Introduction of a mentorship and skill transfer program to enable the aged physicians slowly ease their workload while impacting their knowledge and experience to younger physicians. Implementing flexible retirement options for aged physicians to enable them slowly reduce their working hours and responsibilities while still working part-time. Ensuring public awareness and education fosters understanding and appreciation for the aged physicians’ role in healthcare.
In conclusion, one requires a thoughtful and comprehensive approach to address the issue of aged physicians, considering the patient’s welfare and the physician’s. Ethical considerations should also be part of the approach. Moreover, the aged physicians’ experience and expertise are invaluable and should be channeled to create opportunities to impact the younger physicians.
References
British Medical Association. (2019). Supporting an aging medical workforce – British medical association. https://www.bma.org.uk/media/2073/bma-ageing-medical-workforce-report-feb-2019.pdf
Fortunato, J. T., & Menkes, D. L. (2019). The aging physician: A practical approach to protect our patients. Clinical Ethics. https://doi.org/10.1177/1477750919828163
Kaups, K. L. (2016, October 1). Competence, not age, determines the ability to practice: Ethical considerations about sensorimotor agility, dexterity, and Cognitive Capacity. Journal of Ethics | American Medical Association. https://journalofethics.ama-assn.org/article/competence-not-age-determines-ability-practice-ethical-considerations-about-sensorimotor-agility/2016-10
Lee, L., & Weston, W. (2012, January). The aging physician. Canadian family physician Medecin de famille canadien. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263998/
Palmer, J. (2019, August 29). When is a doctor too old for the job? Patient Safety & Quality Healthcare. https://www.psqh.com/analysis/when-is-a-doctor-too-old-for-the-job/
Powell, T. (2020). OK, Boomer, MD: The Rights of Aging Physicians and the health of our communities. Hastings Center Report, 50(6), 3–3. https://doi.org/10.1002/hast.1191
Seedsman, T. A. (2019). Aging, informed consent and autonomy: Ethical issues and challenges https://www.researchgate.net/publication/333397243_Aging_Informed_Consent_and_Autonomy_Ethical_Issues_and_Challenges_Surrounding_Research_and_Long-Term_Care
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