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Mandatory retirement rules

Credentialing Resource Center Connection, July 15, 2005

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Dear credentialing colleague:

Recently, the Chicago Tribune ran two articles pertinent to this week's topic. The first discussed the mandatory retirement age of pilots flying for commercial airlines such as American, United, etc. The author of the article, a pilot, made a convincing case that passengers would not be well served if the 747 they are sitting in were being flown by two octogenarians. He cited the increased effects of fatigue and stress, decreased reaction time, impaired judgment, and certain promotion and seniority issues as the rational for maintaining a 60-year-old retirement age for such pilots. He ended the article by stating that the effect of age on performance is a subjective matter, thus necessitating a firm rule.

The other article reported on the spectacular career of a suburban physician who had practiced effectively well into his twilight years. No "mandatory retirement age" terminated his medical staff membership or his clinical practice. It is quite possible that this physician recognized any personal limitations and compensated by referring complex cases to colleagues, requesting assistance, or simply listening and providing council to his patients.

These articles reminded me of the many times I've been asked by medical staff leaders if a mandatory retirement age is necessary. This question is usually prompted by the fact that there is a very elderly physician on staff who staff leaders are worried about. In these cases, perhaps medical staffs should consider a policy indicating that practitioners, once they have reached a certain age, will no longer be entitled to independent practice privileges but will still qualify for dependent privileges authorizing them to continue to admit and treat patients in conjunction with another qualified physician. Alternatively, a staff could require that, in the interest of patient safety, elderly physicians be subject to more frequent reappraisals and reappointments or even physical and/or mental competency examinations.

Some readers may worry that these suggestions could constitute age discrimination. However, experienced health care attorneys will quickly point out that sensible efforts to protect the public will not be second guessed by the judiciary and such policies, if adopted by the board and consistently implemented, would be viewed as completely within the discretion of the board of directors.

That's it for this week.

All the best,
Hugh Greeley
http://www.greeley.com/seminars/ 

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