How Should Colleagues Respond to Diminishing Capacities of an Aging Surgeon?

Abstract

When an esteemed elderly colleague needs assistance completing procedures safely, fellow health professionals have the responsibility to respond in order to mitigate risk to patients. There is a strong ethical basis for bringing the surgeon's declining capacity to his or her attention as well as to the attention of others. Ongoing capacity assessments could be one method for tracking diminished capacities among surgeons so that they can stop practicing surgery before putting patients at risk. CaseDr. Roberts is a revered 70-year-old general surgeon at a major university-affiliated hospital, where he has been practicing surgery for almost four decades. He has mentored many generations of surgeons, including his junior colleague Dr. Patel, a 39-year-old surgeon who completed his residency four years ago. Because Dr. Roberts trained and advised him throughout medical school and residency, Dr. Patel holds his long-term mentor in high esteem.

Transition Planning for the Senior Surgeon

“…Mentorship and coaching creates a real opportunity for experienced senior surgeons to pass along important professional lessons and invaluable insights that may be difficult to glean from reading or episodic clinical experiences, such as those into surgical planning, decision making, and error detection, while creating a role for the senior surgeon as an important colleague in the department culture . Consistent with this premise, 37 respondents (47%) in the SSC survey rated mentoring or coaching as a highly important transitioning strategy for senior surgeons, making this the transitioning strategy most frequently ascribed high importance in the survey (Table 1).…”

“…Transitioning strategies should accordingly provide the senior surgeon with ongoing meaningful engagement with their department or institution while providing enough financial support in a defined role to help with financial transitioning to retirement . In some cases, this transition may be facilitated by a switch from primary surgeon privileging to privileges in a consultant or first-assistant role for some interval.…”

The challenge of competency assessment of the late‐career practitioner

“…As a result, it is often difficult for a physician to report a mentor, even in a situation where patient safety might be compromised. 22…”