Document Type
Article
Publication Date
9-2018
Journal Title
BMJ Quality & Safety
ISSN
2044-5423
DOI
10.1136/bmjqs-2018-008276
Abstract
Background Unprecedented numbers of physicians are practicing past age 65. Unlike other safety-conscious industries, such as aviation, medicine lacks robust systems to ensure late-career physician (LCP) competence while promoting career longevity.
Objective To describe the attitudes of key stakeholders about the oversight of LCPs and principles that might shape policy development.
Design Thematic content analysis of interviews and focus groups.
Participants 40 representatives of stakeholder groups including state medical board leaders, institutional chief medical officers, senior physicians (>65 years old), patient advocates (patients or family members in advocacy roles), nurses and junior physicians. Participants represented a balanced sample from all US regions, surgical and non-surgical specialties, and both academic and non-academic institutions.
Results Stakeholders describe lax professional self-regulation of LCPs and believe this represents an important unsolved challenge. Patient safety and attention to physician well-being emerged as key organising principles for policy development. Stakeholders believe that healthcare institutions rather than state or certifying boards should lead implementation of policies related to LCPs, yet expressed concerns about resistance by physicians and the ability of institutions to address politically complex medical staff challenges. Respondents recommended a coaching and professional development framework, with environmental changes, to maximise safety and career longevity of physicians as they age.
Conclusions Key stakeholders express a desire for wider adoption of LCP standards, but foresee significant culture change and practical challenges ahead. Participants recommended that institutions lead this work, with support from regulatory stakeholders that endorse standards and create frameworks for policy adoption.
First Page
468
Last Page
475
Num Pages
8
Volume Number
28
Publisher
BMJ & Health Foundation
Recommended Citation
Andrew A. White, William M. Sage, Paulina H. Osinska, Monica J. Salgaonkar & Thomas H. Gallagher,
Patient safety and the ageing physician: a qualitative study of key stakeholder attitudes and experiences,
28
BMJ Quality & Safety
468
(2018).
Available at:
https://scholarship.law.tamu.edu/facscholar/1597