Assessing Aging & Cognitively Impaired Physicians: Protecting Public Health

🧠 Aging can result in subtle declines in cognitive function, including processing speed, attention, memory recall, and verbal fluency.

👩‍⚕️ Physicians are not immune to cognitive decline, and their work can be negatively impacted if cognitive impairments occur.

📊 Nearly half of practicing physicians in the US are over the age of 55, highlighting the potential magnitude of cognitive decline in this population.

Physicians are at risk of practicing impaired and are unlikely to voluntarily disclose cognitive issues.

A significant number of surgeons continue to operate despite noticing impairments in cognition.

Medical organizations are implementing policies for competency testing and neurocognitive assessments.

🔍 Cognitive deficits may underlie referrals among physicians.

📚 Understanding cultural effects on testing is critical.

💡 Physician performance deficits can be specific to certain concerns.

📝 The study used neuropsychological measures to assess aging and cognitively impaired physicians.

🔍 The researchers established criteria to classify physicians as impaired or ambiguous based on their test scores.

📊 The study found that a cut-off of five or more scores at or below the 5th percentile provided the best separation between impaired and ambiguous physicians.

👥 The study focused on assessing aging and cognitively impaired physicians.

🔬 The study had limitations such as a small sample size and a retrospective study design.

🌍 There is a need for better norms and longitudinal assessments in neuropsychological assessment of physicians.

🤔 Cultural considerations and external validity pose challenges in the assessment of high-functioning individuals.

⚖️ The interpretation of test scores in relation to physician-referenced and general population norms can be complex.

💼 Physicians with lower test scores but performing well on the job raise questions about assessment validity.

Managing cognitive difficulties in aging physicians is challenging due to fear of participation and potential ageism.

Various countries and professions have different policies regarding cognitive assessments and retirement age for physicians.

Recommendations include periodic neuropsychological screening and considering individualized accommodations.

📋 Physicians from different specialties may have different skill sets and strengths.

💡 Referral questions related to physician capacity evaluations vary case by case.

🔬 The study did not control for age and sex, and used urologists as the reference group.

💼 There are ethical and legal considerations regarding screening and mandated evaluations for physicians.