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Should older MDs be subject to mandatory competency tests?

The American Medical Association recently held its annual conference right here in Chicago, with delegates discussing and casting votes on whether certain proposals set forth in advance of the meeting should become official policy.

While most of these policy proposals were less than noteworthy, at least one has medical professionals, hospitals officials and patient safety advocates alike talking.

Indeed, the much-discussed proposal adopted by AMA delegates calls for efforts to be officially undertaken to create preliminary assessment guidelines that can be used to gauge the physical and mental capabilities of older physicians.

According to the AMA, the number of physicians 65 years of age and older here in the U.S. has increased fourfold since the mid-1970s, currently sitting at close to 240,000.  

While all 50 states have laws dictating that medical licenses must be renewed every year or two years, and require a set number of continuing medical education credits to be completed within a designated timeframe, there are currently no mandatory competency exams following initial licensure.

This is a concern, say experts, given the vital nature of the work physicians perform and the fact that they are by no means immune to age-related physical deterioration, including hearing loss, vision problems or diminishing fine motor skills. This is not to mention age-related mental deterioration such as memory problems.

While it remains to be seen what the AMA's competency guidelines will call for in assessing the capabilities of older physicians, it's conceivable that they could end up mirroring the policies already in place at some U.S. hospitals.

For instance, Stanford University now calls for all its physicians 75 and older to undergo a special assessment every two years that includes a physical exam, medical history and performance evaluation.

What are your thoughts on this topic? Do you think this type of testing should become the norm as it can help prevent things like surgical errors, failures to diagnose, misdiagnoses and other medical errors?

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