Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
JAMA Surg. 2019 Jul 1;154(7):647-653. doi: 10.1001/jamasurg.2019.1159.
Aging is well documented to be associated with declines in cognitive function and psychomotor performance, but only limited guidance is currently available from medical professional societies or regulatory agencies on how to translate these observations into the appropriate monitoring of physician performance.
The Society of Surgical Chairs conducted a panel discussion at its 2017 annual meeting and a subsequent survey of its membership in 2018 to develop recommendations for the transitioning of the senior surgeon.
Recommendations include mandatory cognitive and psychomotor testing of surgeons by at least age 65 years, potentially as a component of ongoing professional practice evaluation; career transition discussions with surgeons beginning early in their careers; respectful consideration of the potential financial needs, long-standing work commitments, and work-life concerns of retiring surgeons; and creation of teaching, mentoring or coaching, and/or administrative opportunities for senior surgeons in modified clinical or nonclinical roles. Ideally, these initiatives will catalyze a thoughtful and comprehensive new vista in supporting an aging workforce while ensuring the safety of patients, the efficient management of health care organizations, and the avoidance of unnecessary depletions to a sufficiently sized cadre of physicians with case-specific competencies.
衰老与认知功能和精神运动表现的下降密切相关，这一点已有充分的文献记载，但目前医学专业协会或监管机构提供的指导非常有限，无法将这些观察结果转化为对医生绩效的适当监测。
外科医师学会在 2017 年的年会上进行了小组讨论，并在 2018 年对其会员进行了后续调查，以制定高级外科医师过渡的建议。
建议包括至少在 65 岁时对外科医生进行强制性认知和精神运动测试，可能作为持续专业实践评估的一部分；在职业生涯早期开始与外科医生进行职业过渡讨论；尊重退休外科医生的潜在财务需求、长期工作承诺和工作生活问题；为高级外科医生创造在修改后的临床或非临床角色中进行教学、指导或辅导以及/或管理的机会。理想情况下，这些举措将在支持老龄化劳动力的同时，为确保患者安全、高效管理医疗机构以及避免因特定病例能力的医生数量不足而造成不必要的损失，激发一个深思熟虑和全面的新视角。
