Older surgeons are coming under increasing scrutiny as their competence and ability to practice medicine are called into question especially since many continue to work in their 60s and 70s. The New York Times addressed this in a recent article entitled, “When is the surgeon too old to operate?”
They described an 80-year-old chief of vascular surgery at a New Jersey hospital who was the first doctor evaluated by a new aging surgeon program, which after testing, reported that, “He could capably continue operating.”
According to the American College of Surgeons, “Approximately one-third of all practicing surgeons are older than age 55.” It is clear that certain surgical skills may decline with age, including vision, cognition, and manual dexterity, but it is not at all clear at what age this occurs, and how much it varies from surgeon to surgeon.
One study found higher operative mortality rates for surgeons over age 60, with low surgical volumes performing complex procedures. Another study noted the opposite, “That patients treated by older surgeons had lower mortality than patients treated by younger surgeons.”
Better vision and dexterity in younger surgeons compared to more wisdom and experience in older surgeons. Obviously, the science is not settled.
Should surgeons have a mandatory retirement age, regardless of individual competency? After a decade of education and training, surgeon’s may only have a 30-year working career. With projected manpower shortages in medicine, is it prudent to reduce the workforce on the basis of an arbitrary number? Pilots have a mandatory retirement age of 65 which is exacerbating a pilot shortage in the US.
Pilots and surgeons have much responsibility and hold lives in their hands. Mistakes and lapses in judgement or skill can be deadly. What about other groups that make life and death decisions? Let’s look first at Congress.
The 115th Congress is “among the oldest in history.” The average American is 20 years younger than their Congressional representative. Democratic leaders are two decades than their Republican counterparts, with Democrat leadership averaging 72 years old and Democrat chairs and ranking members at 68 years old, well beyond the pilot retirement age.
Congress makes frequent life and death decisions, such as authorizing and funding the wars in Iraq and Afghanistan, where the death toll is high. Around 7,000 U.S. military members, 8,000 U.S. contractors, and 360 journalists perished in these wars. Add in civilians and opposition fighters, and the death toll tops half a million. How old were those authorizing this war?
Members of Congress voting for Obamacare made a life and death decision for many who lost their insurance or could no longer afford their medical care. Those who could not afford their deductible skipped going to the doctor or hospital, with potentially fatal consequences.
Those currently against border security make a life and death decisions for Americans hurt by the consequences of illegal immigration, such as those hurt or killed by the actions of illegals or the pipeline of illegal drugs crossing the border.
The Supreme Court is also an elderly bunch, with six justices over age 60 and two in their 80s. Justice Ginsburg, age 85 with myriad medical problems, is not the subject of any New York Times article questioning her competency to sit on the high court. These nine mostly elderly justices make life and death decisions for millions.
Abortion rulings have led to the death of tens of millions of babies. Second Amendment restrictions threaten the lives of those trying to defend themselves from bodily harm or death.
Why is age only a concern regarding surgeons, and not government officials? How many decision makers in Washington may be too old to make life and death decisions? Why don’t they undergo competency testing?
How old are some of the presidential hopefuls for 2020? Bernie Sanders is 77, Joe Biden 76, Elizabeth Warren 69. If they were pilots, they would have retired.
The congressional pharmacy reportedly “filled prescriptions for ‘pretty serious health problems’ for members of Congress, including drugs for Alzheimer’s disease.” House Speaker Nancy Pelosi, third in line to the presidency, is 78 years old. Some believe she suffers from senile dementia.
Would a surgeon at that age be allowed to operate? A surgeon may be required to undergo competency testing, but what about politicians? I suspect most voters don’t know the ages of their elected representatives. The ballot box is an ineffective means of assessing competency, as anyone who follows current events understands.
If it is in the public interest to assess the competency of surgeons, why not also assess those high in the halls of power and influence in Washington?
Brian C. Joondeph (@RetinalDoctor), MD, MPS, is a Denver-based physician.
The views and opinions expressed in this commentary are those of the author and do not reflect the official position of The Daily Caller.