The Vancouver Sun ran an excellent article about the extraordinary number of aging physicians in British Columbia who are still practicing medicine. Now, you may have a vision of two or three old codgers showing up at their office long after they should have retired, but that is not the case. Even a dozen or so practicing beyond 65 years old might be acceptable, given the size of the province, but the real number exceeds a thousand, by almost two.
In fact, according to the article, there are about 11,500 doctors actively practicing medicine in British Columbia. Out of them, 14.99% (1,724 to be exact) are over the age of 65, including 174 of them between the ages of 75 and 79, and 90 of them who are aged 80 years old and over! That begs the question: At what age should physicians be required to retire? According to the government, there is no age.
B.C. abolished mandatory retirement in 2008, and since then, a growing number of doctors have chosen to continue practicing. Dr. Ailve McNestry, deputy registrar of the College, said doctors continue working for the same reasons that others choose to — they derive much satisfaction from it, their identities are wrapped up in their professional lives, and they need or want the income.
But, the College of Physicians and Surgeons of B.C. says that older doctors have a duty to retire before declining mental or physical health harms patients. And, the 2013/14 report from the Inquiry Committee in the College’s annual report states, “Ideally, every physician will perform optimally on his or her last day of practice.”
The committee handles about 1,000 complaints a year, covering doctors’ clinical performances, abilities, conduct/ethics, and boundary violations (sexual and other inappropriate conduct with patients) from concerned patients, and even colleagues!
The committee, which handled about 450 files related to doctors’ clinical performances, including allegations of deficiency on the part of older doctors, stated, “As in the past, the committee investigated a number of complaints alleging deficient performance by older physicians. Many of these triggered investigations.”
The college says experts in occupational performance found older professionals excel when they “stick to familiar tasks and settings”. Yet doctors who are preparing to retire often close their practices and work at walk-in clinics. And there, because they don’t have a history with patients, make errors that they normally wouldn’t have made treating patients they knew well.
The College’s Medical Practice Assessment Committee provides oversight to a program that assesses and educates doctors. The program prioritizes assessment of doctors over age 70, especially those who work in solo offices. While all doctors working in the community are suppose to have an assessment every eight years (as opposed to hospitals), those in their 70s are assessed more frequently — as are those who require ongoing scrutiny.