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March 27, 2018
Older doctors are considerably more likely to be the subject of an AHPRA notification than their younger peers, according to new research. The University of Melbourne study, which looked at all 12,878 notifications lodged with Australian medical regulators over a four-year period, found doctors over the age of 65 had 37% more notifications than their younger peers, aged 36 to 60.
The type of notification varied substantially between the two age groups. Health-related notifications, covering both physical illness and cognitive decline, were twice as high among older doctors. They were 40% higher for conduct-related notifications and 10% higher for performance-related notifications, compared with younger doctors. The researchers from the Melbourne School of Population and Global Health said they had identified several "hot spots" of risk for older doctors. One of these was the prescribing, use and supply of medicines.
"Some older doctors are known to maintain registration in order to prescribe for themselves of for families and friends. Whilst this practice is in breach of 'Good medical practice: a code of conduct for doctors in Australia', some older doctors have been slow to adapt to evolving professional standards," the researchers noted. They also pointed to some older doctors' failure to keep abreast of new drugs or changes in drug regimens, their reversion to older, more familiar patterns of practice, and their reluctance or inability to follow new protocols.
"Well documented age-related declines in cognition and physical abilities in the general population are likely to be reflected in the health practitioner community with possible implications for safe clinical decision-making," the authors write. "Previous research suggests that some health practitioners lack the ability or insight to self-assess competence and may not be aware of a decline in their cognitive ability or skills."
But the authors note there are no internationally recognised thresholds of cognitive impairment at which a doctor is considered to be a risk to the public. The study follows reforms proposed by the Medical Board of Australia late last year that would require doctors aged 70 and over to prove they are competent to continue practising. The reforms would require peer review and health checks for these doctors to be incorporated into their CPD requirements. The health checks would include issues such as cognitive function, eyesight and hearing. But there have been no moves towards introducing a mandatory retirement age for doctors.
You can access the study on older doctors and notifications here.
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