People trust that their doctors and surgeons are competent and believe there is some sort of system for protecting patients from incompetent physicians. Doctors are subject to rigorous licensing requirements. However, there is not a system in place to proactively protect patients from physicians whose skills have eroded. The present system of medical discipline does not go into action until after a medical mistake has already been made.
All of us will inevitably lose some skills as we age, and physicians are not immune to the effects of age. With nearly one-third of physicians over the age of 65 and that proportion likely to rise, physicians with eroding skills are becoming a very real cause for concern. While physically demanding careers often require mandatory screening and mandatory retirement at a certain age, no such screening exists in the vast majority of U.S. hospitals.
Typically, a doctor does not face any sort of competency screening until a state medical board has instituted disciplinary proceedings. A 2005 study found that 6.6 percent of doctors out of medical school for 40 years or more faced disciplinary action, compared with only 1.3 percent for doctors out of medical school only 10 years.
Physicians are required to take continuing medical education courses in order to continue practicing medicine, but there are often no regular physical and cognitive evaluations for physicians. Mild cognitive impairment is not something most people will notice in themselves. Many physicians are not aware that their skill and performance is declining. At first, a person may lose the ability to recall certain words or medical terminology, learn new things and apply knowledge. Usually, others will only notice a change when a physician behaves unusually. Eventually, cognitive problems can have a detrimental effect on the effectiveness of care a physician provides and medical malpractice is an unfortunate result.
Source: New York Times, "As Doctors Age, Worries About Their Ability Grow," Laurie Tarkan, 1/24/2011