The current issue of Annals of Surgery (subscription required), and reported by AP/Yahoo, suggests that older surgeons should not be doing certain more complex procedures, and that a tapering down of surgery loads may not be the best way to move towards retirement.
In a study of 461,000 Medicare patients, surgeons over 60 years old had higher death rates than younger surgeons for pancreas removals, heart bypasses and surgery to clear blocked carotid arteries. For five other surgeries, age did not seem to be a factor.
The study also suggested that “practice makes perfect” – that tapering down their surgical caseloads may result in surgeons losing critical skills that they could otherwise perform well. In the AP report, study co-author Dr. John Birkmeyer of the University of Michigan said, “Practice keeps skills high, so an all-or-nothing approach to surgery in the pre-etirement years may be better than gradually fading away.”
The AMA reports that the percentage of working doctors 65 and older climbed from 13 percent in 1975 to 18 percent in 2004, That number will climb higher as the wave of baby boomers ages.
For practices, the more immediate concern is how surgeons should taper off their practice as they turn it over to a new physician. From a public policy perspective, the issue is how to fairly evaluate surgical capability as one ages.