Which is more difficult: taking away Grandma’s car keys or telling a doctor he’s “too old” to practice medicine anymore? Should there be a mandatory retirement age for physicians as there is for commercial airline pilots?

The physician workforce is America is not getting any younger; in fact, it’s getting older. A recent survey in Virginia found that at age 65 more than one-third of physicians still in practice were working at least part-time.

Dr. Peter Carmel, president of the American Medical Association, is a pediatric neurosurgeon still operating at the age of 75. “America’s patient population needs us,” says Dr. Carmel (amednews.com, April 30, 2012). “This country is facing a shortage of doctors to meet the needs of our growing and aging population.” Filling this gap, however, cannot be a trade-off for making certain that all patients have access to quality care.

The consensus in the medical profession is that clinical performance, not age, should determine whether or not a physician should be asked to step aside. Yet, physicians themselves are probably not the best judge of their competency. If that’s the case, how does one “take away the keys” when an older physician wants to keep practicing? Should there be an annual recertification at some point, perhaps age 70? Or, should there be mandatory peer evaluations for all physicians over a certain age?

Facing the “R-word” is not easy, especially when one’s personal identity is so tied to their profession.

Ken Teufel, M.D.

Ken Teufel is the Medical Director for Interim Physicians