When is a surgeon too old to practice?

After nodding off during an operation he was observing in the fall of 2015, Herbert Dardik, MD, who was 80 years old at the time, said hospital leadership immediately called on him to reduce his workload and undergo testing to evaluate whether he could continue practicing medicine safely.

In an interview with The New York Times, Dr. Dardik, the chief emeritus of vascular surgery at Englewood (N.J.) Health, said he had undergone a minor medical procedure a few days before the scheduled surgery and told his patient another surgeon would perform her operation. He said the patient insisted he at least be present.

"I was really an accessory," he said, stating that the operation "was so boring, I kind of dozed off" — and was reported to hospital leadership by an alarmed nurse anesthetist. The hospital's chief of anesthesiology and CMO both paid a visit to Dr. Dardik's office to suggest a lighter workload.

"I got so annoyed, I stood up and opened the door and said, 'Get out.' Who knows better what I can do but I myself?" he said.

However, not long after, Dr. Dardik said he found himself on a plane questioning the capabilities of the older-looking captain.

"It hit me like a hammer — this is what other people think when they look at me," he said.

Data from the American Medical Association cited by The New York Times notes that almost 25 percent of practicing physicians were 65 years or older in 2015. In 2017, more than 122,000 physicians in that age group said they continued to engage in patient care.

After his realization on the flight, Dr. Dardik became the first physician to be evaluated by Sinai Hospital's aging surgeon program. The program aims to evaluate older surgeons' capabilities to ensure they are still physically and mentally able to provide patient care. Now in its fifth year, Sinai Hospital's program has screened a total of eight surgeons, ages 55-81, the report states.

Research is split on whether older surgeons have poorer outcomes than younger surgeons, and many physicians often resist suggestions to slow down or retire. Mandatory retirement ages may be a viable option, but such limits could also violate discrimination laws and sideline competent physicians.

"Being a physician is at the core of their identity. It becomes something they can't let go of. They can't imagine retiring," Glen Gabbard, MD, a psychiatrist at the Houston-based Baylor College of Medicine, told the publication. Dr. Gabbard specializes in psychological evaluations of physicians.

To access the full report, click here.

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