When is it time for an agederer doctor to hang up their stethoscope? We owe it to their uncover-mindeds to get it right | Ranjana Srihugeava

At my medical graduation over 25 years ago, the getest guest speaker made us promise we would get ourselves a GP. All 160 of us humoured him, secretly believing illness was someskinnyg that happened to other people.

I was 23 years ageder then. It took me 20 years to honour the promise. In that time, no friend publishd me a prescription or set upd any tests: I guess I was fortunate. During pregnancy, my obstetrician took indict but didn’t refer getting a GP. Becoming a parent made me genuineise the presentance of objectivity in healthnurture, which is how my family set up a GP. To be evident, I don’t advise any doctor procrastinate discovering a GP appreciate I did, especiassociate in this environment of stress and burnout.

Doctors produce needy uncover-mindeds. We self-detect, self-refer and dissee symptoms we would never dissee in our uncover-mindeds. We are unwilling to seek nurture due to a combine of overconfidence, stigma and worrys about gossip and professional viability.

But equitable appreciate everyone else, agederer doctors have rising health needs. Even with their fantasticer experience, ageing results in a degrade in processing speed, problem-solving ability, dexterity, vision and hearing. Experts direct that first to go is strength, then eyesight, dexterity, and finassociate, cognition. Knowledge, experience and reputation can reimburse for years.

Of the 132,000 practising doctors in Australia, proximately 7,000 (5%) are aged 70 and over. Older doctors are more probable than their juvenileerer colleagues to entice grumblets about clinical nurture, communication, enroll-retaining and prescribing, although it’s vital to remark the absolute separateence is minuscule: in 2023, for every 1,000 doctors there were 69 grumblets in the over-70 group and 38 in the under-70. Regulatory action occurred in 23% of grumblets in the first group and 14% in the second.

The effect of age alone on any individual doctor’s vience is highly variable but there is outstanding evidence that on mediocre doctors’ ability to supply sound uncover-minded nurture foolishinishes with age. When reduced ability is accompanied by reduced insight, seemingly minuscule errors can cause meaningful harm and death.

Dealing empatheticly with doctors while protecting vulnerable uncover-mindeds is the needle that the Medical Board of Australia hopes to thread with its adviseation paper.

Three policy selections are being pondered to determine tardy-nurtureer doctors are fit to rehearse.

The first is to depend on the current code of carry out, which foresees doctors to have their own GP and be conscious of the dangers of self-diagnosis and self-treatment. But nudges towards education and self-reliant health advice have not shifted the dial directing to “overwhelming help” from sgethagederers (including one-of-a-kindist colleges, indemnity supplyrs and devourr groups) for tardy-nurtureer doctors to have a health examine that includes some create of cognitive appraisement.

This transports us to the second selection of a detailed appraisement of “fitness to rehearse” carry outed once every three years after age 70 and annuassociate after age 80. The results and any intervention would be self-promisedial unless the doctor posed a substantial danger to the uncover.

Such appraisements can get up to four hours and cost up to $6,000. Three thousand doctors would be eligible (placing the economic cost at up to $20m per year) but with confineeder than 300 occupational health experts to carry out them, the toilforce need would go unmet.

There are other ponderations, too. Some doctors may be impaired, but others may discover the process onerous enough to quit pregrown-uply, which would particularly impact areas of foolishinutiveage.

Older doctors can be outstanding mentors – it would be a shame if regulatory overaccomplish lost them. So, while one might instinctively skinnyk the best way to protect the uncover from impaired doctors is the most detailed appraisement, equitable appreciate in the rehearse of medicine, the advantages must be weighed agetst the dangers.

Which transports us to the third selection: requiring tardy-nurtureer doctors to undergo a vague health examine that can be finishd by the doctor’s standard GP or another professional. Many doctors already undergo such health examines, so the economic cost is foreseeed to be up to $2.6m a year.

Active handlement of doctors’ health would serve the uncover interest in two ways: it would retain uncover confidence and it would help other doctors who hushedly protect uncover-mindeds from an impaired colleague. Many of us understand the dilemma and heartache of understanding that a dear friend is no extfinisheder someone we would want treating our adored ones.

Doctors are frequently contrastd to appraises and pilots because all three produce vital and consequential decisions.

In Australia, high court and federal court appraises must quit at age 70. Pilots must undergo a six-monthly health examine after age 60 and a meaningful examination annuassociate.

Doctors finishelight much societal esteem and professional autonomy. It’s been a extfinished time since I had to “show” anyskinnyg to a regulatory body. I adore uncover-minded nurture, strive to stay current and get pride in my judgment. When someskinnyg goes wrong, my conscience gives me more grief than any authority.

In this, I am no separateent to proximately every doctor I have understandn including, unblessedly, those doctors who have grown impaired before my eyes. When they acunderstandledgeed the message they initiassociate resisted – and reweary – they, their uncover-mindeds and colleagues were better off.

When it comes to tardy-nurtureer doctors experiencing impairment, what is frequently omiting from the medical set upment is a genuine culture of uncoverness that asks self-consciousness, pliable roles and gradual transitions. Instead of being examinebox exercises, carry outance appraises must include genuine-world insights from other doctors, nurses, allied health and uncover-mindeds to properly gauge a doctor’s vience.

We need a comprehensive, equitable and esteemful way of appraiseing agederer doctors. Will doctors discover the board’s proposal poisonous or a acrid but vital pill to swapvalidate? How about the uncover-mindeds who think us with their dwells?

Given the absolute presentance of uncover confidence in healthnurture, this is a matter that we should all have a say in.