For decades, experienced physicians have served as mentors, innovators, and trusted healthcare providers. Many continue practicing well into their 70s, bringing decades of clinical knowledge and judgment that younger physicians simply cannot replicate. However, as the physician workforce ages, hospitals are facing a difficult question: How can they ensure patient safety while treating senior physicians fairly and respectfully?
A recent article from the Association of American Medical Colleges (AAMC), “A Growing Dilemma for Hospitals: How to Assess Older Doctors,” explores how health systems across the country are addressing this increasingly sensitive issue.
An Aging Physician Workforce
The need for these conversations is growing rapidly. According to the AAMC, nearly 24% of practicing physicians are now 65 years or older, a significant increase from just over 16% a decade ago. As more physicians choose to extend their careers, hospitals must find ways to evaluate competency without relying solely on age or assumptions.
While many physicians maintain exceptional clinical skills throughout their careers, research has shown that certain cognitive and physical abilities, including memory, vision, reaction time, and manual dexterity, can decline with age. Importantly, these changes vary greatly from person to person, making individualized assessments more appropriate than blanket retirement policies.
Moving Beyond Reactive Evaluations
Traditionally, hospitals have addressed concerns only after colleagues or patients reported changes in a physician’s performance. The AAMC article notes that this reactive approach often leaves hospitals responding after problems have already emerged.
As Dr. Mark Katlic of LifeBridge Health explains in the article:
“There’s such enormous variability among individuals. That’s why you need some type of screening evaluation for each person.”
Several health systems have responded by implementing late-career practitioner assessment programs that proactively evaluate physicians once they reach a certain age, typically between 70 and 75, during the credentialing process.
What Do These Assessments Include?
The evaluations vary by institution but commonly examine:
- Cognitive function and memory
- Vision and hearing
- Physical health
- Manual dexterity
- Executive functioning and decision-making
Organizations such as LifeBridge Health, the University of Virginia Health System, the University of Pennsylvania Health System, and Yale New Haven Health have each developed their own assessment models, often integrating these evaluations into routine credential renewal.
Most physicians successfully complete the assessments without any changes to their clinical privileges. In a small percentage of cases, however, results may lead to additional testing, modified clinical responsibilities, accommodations, or retirement discussions.
A Delicate Balance
Perhaps the greatest challenge is balancing patient safety with fair treatment of experienced physicians.
Many senior physicians view mandatory age-based testing as discriminatory, arguing that years of successful practice demonstrate their competence. Others point out that experience often compensates for minor physical changes and that older physicians provide invaluable mentorship and institutional knowledge.
Complicating matters further, the U.S. Equal Employment Opportunity Commission (EEOC) has challenged one hospital system’s age-based screening policy, raising legal questions about whether mandatory testing based solely on age violates federal employment laws. Some states have also enacted legislation limiting age-based physician assessments.
Why This Matters for Healthcare
Healthcare organizations are already facing significant physician shortages. Encouraging experienced physicians to retire prematurely could worsen access to care, particularly in underserved communities.
At the same time, hospitals have an obligation to ensure every physician, regardless of age, can safely provide patient care. Many experts believe confidential, evidence-based assessments combined with supportive interventions offer the best path forward.
Rather than viewing these evaluations as punitive, many organizations are framing them as part of physician wellness and quality assurance programs designed to support clinicians throughout every stage of their careers.
Looking Ahead
The conversation surrounding late-career physicians is likely to become more prominent as the medical workforce continues to age. Hospitals, medical societies, and policymakers will need to develop approaches that respect the expertise of veteran physicians while maintaining the highest standards of patient safety.
Ultimately, the goal is not to determine when physicians should retire, but to ensure that every clinician, regardless of age, is practicing at the highest level possible. By adopting fair, individualized assessments, healthcare organizations can preserve the invaluable contributions of experienced physicians while protecting the patients who depend on them every day.