Revisiting Age and Competency in Healthcare: A Global Perspective
The image of a seasoned doctor, composed and confident, commands respect within the healthcare system, especially in countries like India. However, as the medical workforce ages, an important question arises: Who ensures that the judgment, memory, and decision-making of aging physicians remain sharp? A recent report from The New York Times highlights how U.S. hospitals are starting to implement cognitive and competency testing for older doctors. This debate, according to experts, is not about ageism but is fundamentally about patient safety and professional accountability. Alarmingly, this critical conversation seems to be largely absent from India’s policy discussions.
Despite the rising life expectancy and the trend of physicians practicing well into their seventies and eighties, India lacks a formal mechanism to assess the cognitive fitness of aging medical professionals. This oversight poses potential risks to patient care unless it is addressed proactively.
Aging Medical Workforce: A Global Issue
Globally, more doctors are continuing to practice at older ages than ever before. In the U.S., nearly 20% of physicians are over 65, according to recent workforce data. While age brings experience, it can also lead to cognitive decline, slower reaction times, and memory issues. In response, some American hospitals have initiated cognitive screenings starting at the age of 70. This practice has sparked intense discussions regarding fairness, discrimination, and safety.
“These measures are not punitive,” hospital officials clarified, as reported by The New York Times. “They aim to identify risks early and provide support to physicians before a situation becomes harmful.”
The Silence Surrounding Cognitive Assessments in India
In striking contrast, India currently has no legal requirements established by the National Medical Commission (NMC) for routine cognitive or competency testing based on age. Instead, the healthcare system depends heavily on self-assessments, peer evaluations, and institutional oversight—methods that critics argue are inconsistent and often ineffective.
To delve deeper into the implications of this issue, we consulted Dr. Raghavendra Prasad, a senior physician and expert in healthcare policy.
Experience vs. Cognitive Fitness
Dr. Prasad has over 30 years of experience in clinical practice and medical education. He states, “Medicine is one of the few professions where declining cognitive ability can have immediate and irreversible consequences. Experience is invaluable, but it cannot replace cognitive fitness. Both must coexist for safe practice.”
He emphasizes that the absence of formal guidelines in India does not negate the existence of the problem.
“We are all living longer, including doctors,” he noted. “However, biological aging affects everyone. To believe that doctors are immune to cognitive decline is both unrealistic and unsafe.”
Addressing Stigma and Ageism Concerns
A significant barrier to introducing cognitive assessments in India is the fear of stigma. Dr. Prasad explains, “There is a genuine concern that such testing may be perceived as disrespectful or ageist. However, how we frame these assessments is crucial. If we present them as supportive tools rather than a means to remove practitioners, acceptance is more likely.”
He highlights that pilot programs in the U.S. incorporate confidential evaluations, remediation plans, and role transitions rather than immediate removal. “A senior surgeon struggling with fine motor skills could still be an exceptional mentor or diagnostician,” Dr. Prasad added. “The focus should be on safe redeployment, not forced retirement.”
Learning from Global Practices
India does not need to adopt Western models wholesale, according to Dr. Prasad; instead, it requires structured thinking. “Beginning with small, voluntary assessments at a designated age, periodic peer-reviewed competency checks, or hospital-level policies could be effective steps forward,” he suggested. “Ignoring the matter entirely is the worst approach.”
He also stresses the importance of medical councils and large hospital networks leading this conversation. “Policy changes often follow cultural shifts. We must first acknowledge that this issue exists.”
Patient Safety Must Be Central
Ultimately, this discussion revolves around patient safety. Many patients mistakenly believe that a valid license guarantees a physician’s competence.
As India’s healthcare framework expands and the incidence of medical litigation rises, experts caution that the consequences of inaction may carry both legal and ethical ramifications.
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