Debate swirls over age-based physician screenings

A physician is suing Henry Ford Health in Detroit for age discrimination, casting a spotlight on an ongoing debate that strikes at the heart of patient safety and medical professionalism: age-based cognitive assessments for physicians.

In 2021, about 47 percent of physicians were age 55 and older, according to data from the Association of American Medical Colleges. The number of physicians 60 and older has also increased by 54 percent since 2010, according to the Federation of State Medical Boards.

As the healthcare industry navigates an aging workforce and evolving standards of care, the question of whether to implement cognitive assessments based on age is dividing opinions. While some argue that these assessments are crucial for patient safety, others contend that they may undermine the invaluable experience and wisdom of older physicians.

Lylas Mogk, MD, an 84-year-old ophthalmologist, has worked at Henry Ford since 1995. She filed a lawsuit against the system and the Henry Ford Medical Group in September over a policy that requires cognitive assessments for those 70 and older, CBS News Detroit reported Oct. 19. Testing is required annually after physicians turn 75, and those who don't comply must voluntarily resign or be terminated. A Henry Ford spokesperson told Becker's it could not comment on pending litigation. 

The lawsuit comes about three years after the U.S. Equal Employment Opportunity Commission filed suit against Yale New Haven (Conn.) Hospital, alleging its policy mandating eye and neuropsychological exams for employees age 70 or older who seek medical privileges violates two federal antidiscrimination laws. The lawsuit is ongoing. 

"Yale New Haven Hospital's late career practitioner policy is designed to protect our patients from potential harm while including safeguards to ensure that our physicians are treated fairly," a Yale New Haven spokesperson told Becker's in 2020. "The policy is modeled on similar standards in other industries and we are confident that no discrimination has occurred and will vigorously defend ourselves in this matter."

Proponents of age-based physician screenings have pointed to age-related cutoffs for professionals in other industries that affect public safety. For example, commercial airline pilots are regularly screened at age 40 and no longer permitted to lead flights after age 65. 

The American Medical Association notes that age is just one factor of many that can determine physician competence. In 2021, the association issued a report with best practices for assessing competence for all physicians — not just seniors.  

"Several factors associated with aging may impact physicians' analytical processes, such as decreasing working memory, declining visual acuity and slowing speed of mental operations," the association said. "Still, the effect of age on any individual physician's competence can be highly variable. While age is one factor in predicting potential competence, other factors such as practice setting, clinical volume, specialty and stress also can contribute."

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