According to the American Medical Association (AMA) Council on Medical Education, there were 50,993 practicing physicians aged 65 years or above in 1975; in 2013, the number had increased to 241,642 physicians (a 374% increase).1 In 2017, 44.1% of 103,032 active US surgeons were 55 years or older, with a percentage that varied by surgical specialty, ranging from a low of 40.9% in vascular surgery to a high of 58.1% in thoracic surgery.2 A recent report by the American Association of Medical Colleges (AAMC) found that 27% of the current physician workforce is between the ages of 55 and 64 and that physicians 65 years or older represent an additional 15% of the total workforce.3 These findings suggest that 42% of the entire physician workforce is 55 years or older.3

The issue of aging physicians poses serious challenges to the medical profession, with concerns that judgment or skills might decline with age.4 Approaches that have been proposed included a possible mandatory retirement age for physicians, similar to the mandatory retirement age used in the airline industry for pilots, but these have been met with protests regarding age discrimination as well as other concerns.4

In 2015, the AMA Council on Medical Education’s report “Competency and the Aging Physician” called for “guidelines/standards for monitoring and assessing both their own [each physician] and their colleagues’ competency.”1 In 2016, the American College of Surgeons (ACS) likewise issued a statement regarding the aging surgeon, rejecting the notion of a mandatory retirement age and encouraging surgeons to “adhere to a lifestyle that promotes wellness,” focusing on the surgeon’s “fitness” to engage in medical/surgical practice, and relying on surgeon self-report or the report of colleagues and hospital staff of any concerns.5

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To shed light on this complex and challenging topic, MPR interviewed 3 experts with differing viewpoints on how to approach the issue.

Robert Sataloff, MD, DMA, Professor and Chair of Otolaryngology and Senior Associate Dean for Clinical Academic Specialties, Drexel University College of Medicine, Philadelphia, PA, is the Chairman of the Boards of Directors of the Voice Foundation and of the American Institute for Voice and Ear Research. Dr Sataloff is the coauthor of “The Aging Physician and Surgeon.”6

E Patchen Dellinger, MD, is Professor Emeritus, Department of Surgery, University of Washington, Seattle and Associate Medical Director of the University of Washington Medical Center. He is on the management committee of the Surgical Care and Outcomes Assessment Program (SCOAP) and chairs the Surgical Checklist Initiative for Washington State sponsored by SCOAP. Dr Dellinger is the coauthor of “The Aging Physician and the Medical Profession: A Review.”4

David Weiss, MD, is an internist and pulmonary specialist at Parkchester Medical Services Clinic, Bronx, NY.

This article originally appeared on MPR