Orthopedic surgeon Ralph Blasier agrees. In a 2009 review article entitled “The Problem of the Aging Surgeon,” Blasier wrote that “essentially every treatment technique taught 25 years ago has been abandoned and replaced,” including the treatment of traumatic fractures and joint diseases. “All surgical specialties,” he continued, “have had similar turnover of treatment methods.”
Blasier, 62, who practices in Escanaba, Mich., has cut back his practice in recent years. He no longer performs certain demanding operations, such as arthroscopic shoulder surgery, because he doesn’t think he does them as well as he did at age 50, when he was at his peak.
One reason Blasier believes doctors are loath to retire is that they haven’t planned for it. Five years ago, he earned a law degree from Wayne State University and is handling several legal cases, in addition to his reduced surgical practice. In a few years when he retires, he plans to practice law.
“If I screw up a legal case,” he said, “nobody dies.”
At Stanford, Weinacker, chief of the 1,800-member medical staff, said that reaction to the policy, which currently affects about 25 doctors, has been mixed. Several doctors, she said, have decided to retire instead of undergoing testing. “I think the main thing I stressed with people was that this policy is intended to be supportive,” not punitive. Anyone found to have problems will be referred to the PACE program for a more complete evaluation.
At U-Va., Schorling said that 28 of the 35 doctors older than 70 completed screening and passed easily. The other seven decided against participating and no longer have hospital privileges there, although they are free to practice elsewhere.
Still practicing at 101
Rheumatologist Ephraim Engleman, who will turn 102 in March, said he plans never to quit.
One of the nation’s oldest practicing physicians, Engleman drives from his San Mateo home to the sprawling medical campus of the University of California at San Francisco three days a week. There he sees about eight longtime patients per week and spends most of his time directing the Rosalind Russell Medical Research Center for Arthritis, an administrative post he has held since it was created in 1979.
“I’m very much opposed to retirement,” said Engleman, an accomplished violinist who plays once a week with a chamber music group. “As long as I’m able intellectually and physically, I’m going to continue.” Engleman, who graduated from medical school in 1937, loves being a doctor and said, “I can do everything I ever did.” His only impediment, he said, is severe spinal stenosis, which has left him stooped and dependent on a cane. “I walk like an old man,” he said.
Informed that Stanford, his undergraduate alma mater, has recently begun requiring doctors older than 75 to be tested, he quipped, “I’m glad they don’t do it here.” But Engleman said that he is not opposed to such evaluations and that he has asked his colleagues to tell him if they believe he is slipping. “By all means, let me know — and I’ll get the hell out of here,” he said he told them.
Kaiser Health News is a service of the Kaiser Family Foundation, a nonpartisan health-care-policy research organization unaffiliated with Kaiser Permanente.