Under federal rules, commercial airplane pilots over age 40 must have more frequent medical and cognitive exams than younger pilots. And for safety reasons, all commercial pilots must retire by age 65. To me, that makes a lot of sense. But physicians, who have the lives and health of their patients in their hands every day, have no similar legal requirements. In fact, once physicians are licensed to practice, they are not required to be physically or mentally examined or tested for competence ever again in order to maintain that license.

Now that more than one-third of America’s physicians are over age 65—and the numbers keep growing every year—several large health-care systems are requiring older doctors on their staff to be physically and cognitively examined in order to maintain their credentials and privileges in their systems. If this type of program is not being used in your health-care system, be alert for signs that your doctor’s competency may be impaired. Red flags to watch out for…

Red Flag #1: Forgetfulness.A friend of mine stopped seeing his dermatologist when the doctor kept forgetting my friend’s name. He also forgot to order tests he said he would set up. And when biopsy reports came back, the doctor did not call with the results. Forgetfulness, particularly in someone who has always been mentally sharp and organized, signals a possible cognitive issue. You can report this (see below), but in the meantime, consider finding a new doctor.

Red Flag #2: Indifference.A good doctor is warm, helpful and concerned. If the doctor is rude, dismissive of your concerns or symptoms and/or cold or indifferent when he/she has not behaved this way in the past, it is often a sign of burnout. These doctors often criticize the system they work for or the insurance companies they must deal with. But their anger can translate into poor care. 

Red Flag #3: Not staying up to date. A reader wrote me about a urologist he had seen who brushed off his questions about robotic surgery for his prostate cancer by simply saying, “It’s not my cup of tea.” With a few more questions, the patient realized that the doctor felt he was too close to retirement to learn a new skill. The patient went to a teaching hospital in another city and was given several options, including robotic surgery. My friend chose this type of surgery, and he got good results. Many older doctors are often reluctant to try new techniques or prescribe newer drugs. That means the onus often falls on you to research the various treatment options available for your condition. 

How to Take Action if You Think Your Doctor is Impaired

If you suspect that your doctor’s competence is impaired by his age (or, for that matter, by alcohol, drugs or any other factor), you can file a complaint with your state medical licensing board. To contact your state board, go to FSMB.org/contact-a-state-medical-board. If the doctor is hospital-based, contact the hospital’s medical director. If the doctor works in a large group practice, ask for the practice manager. Depending on the findings, the physician may have his license revoked or suspended or be asked to give it up.

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