Wrong Diagnosis by American Medical Assn?

The American Medical Association has plunged headlong into the controversy about age discrimination in the medical profession by adopting a plan to develop criteria to review “”Senior/Late Career”  doctors’ physical and mental health and patient care.

At its annual meeting last month, the AMA unanimously adopted a plan to spearhead an effort to evaluate elder healthcare providers’ on-the-job effectiveness. The plan was proposed by the AMA’s Council on Medical Education.

The action comes on the heels of a dispute at Stanford University, where the Faculty Senate in May demanded repeal of a 2013 requirement that medical faculty aged 75 and older undergo enhanced health screening and peer assessment to retain their jobs.

Like Stanford University, the AMA fails to provide any research or evidence whatsoever explaining why it is necessary to screen “senior” physicians.

The AMA policy states that it will “identify organizations that should participate in the development of guidelines and methods of screening and assessment to assure that senior/late career physicians remain able to provide safe and effective care for patients.” These organizations must then  “work together to develop preliminary guidelines for assessment of the senior/late career physician and develop a research agenda that could guide those interested in this field and serve as the basis for guidelines more grounded in research findings.”

Apparently, the AMA has decided there is a need for a plan and will now develop the research necessary to support that conclusion.

In the absence of any evidence that a plan is even necessary, one cannot help but speculate that ageist stereotypes against older workers have played a role in the AMA’s decision-making. These stereotypes include unsupported concerns that older workers are less competent, can’t learn new things, are rigid and quarrelsome, and refuse to accept they should step down and make room for younger doctors..

The AMA states that the number of U.S. physicians 65 and older has quadrupled since 1975 and now totals about 240,000, or roughly one out of every four doctors.

The AMA notes that public safety personnel in fields where error can result in the loss of life are subject to mandatory retirement but not physicians.The AMA fails to note, however, that mandatory retirement provisions were included in the ADEA without any valid scientific basis. The retirement age for public safety workers- 55 –  is completely arbitrary.

In my book, Betrayed: The Legalization of Age Discrimination in the Workplace, I note that the AMA supported the ADEA in 1967 and opposed mandatory retirement as being extremely harmful to the health of older workers.

The AMA called mandatory retirement the “arbitrary segregation of individuals because of arbitrarily determined chronological age.” 

Arbitrary is a word that comes up often when discussing the age at which individuals lose capacity in the workplace.

Most people would agree that many  pilots, police officers, and firefighters who are forced to retire are better qualified than younger officers who are physically slight, smokers and alcoholics, couch potatoes, or who suffer from a debilitating chronic health condition. For example, Andreas Lubitz, 27, the co-pilot of Germanwings Flight 9525, recently killed himself and all 150 people on board by flying the plane into a mountain. Lubitz,had gone to 41 doctors complaining of severe depression and failing eyesight.. Yet, no one is talking about testing the mental or physical health of 27-year-olds.

At the same time, if there is a need to protect the public, then by all means do so. But it should not asking too much to require the AMA to provide evidence that such a need exists before it violates the Age Discrimination in Employment Act.

The AMA has not picked an age at which physicians would be subjected to its interference, stating, “Physicians should be allowed to remain in practice as long as patient safety is not endangered,.”

What does the AMA mean by “endangered.”   Lots of people live in small towns where there are no physicians,largely  because the AMA has been so successful in limiting opportunities for medical education.  And lots of Medicaid patients can’t get health care to which they are entitled because no physician in their community will take Medicaid. I’m sure the AMA will promptly address these issues.

The ADEA, by the way, subjects other workers to mandatory retirement for no good reason, including business executives and state court judges. Federal judges serve for life and many continue to work well into their 90s, occupying an office in the federal building, employing staff and earning a paycheck.

* Note the actual AMA report on this issue is not available to the public. It can be found on the AMA’s web site but  you must log in to actually see the report.

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