12h00 02/12/2019 | Opinion

Brian Joondeph | Doctor

Older surgeons are under increasing scrutiny as their competence and ability to practice medicine is challenged, especially as many of them continue to work in their sixties or seventies. The New York Times address this in a recent article entitled "When is the surgeon too old to operate?"

They described an 80-year-old chief of vascular surgery in a New Jersey hospital who was the first physician evaluated by a new program of aging surgeons. After a test, reported that, "He could continue to function with talent."

According to American College of Surgeons, "About one-third of all practicing surgeons are over the age of 55." It is clear that some surgical skills may decrease with age, including vision, cognition, and manual dexterity, but it is not clear how old is this? and how much it varies from one surgeon to another.

A study found higher operative mortality rates among surgeons over 60 years of age, with small surgical volumes performing complex procedures Another study noted the opposite: "The mortality rate of patients treated by older surgeons was lower than that of patients treated by younger surgeons."

Better vision and dexterity among younger surgeons compared to more wisdom and experience among older surgeons. Obviously, science is not settled.

Should surgeons have the age of mandatory retirement, regardless of their competence? After a decade of education and training, the surgeon only has a 30-year career. Given the anticipated labor shortage in the medical sector, is it prudent to reduce the workforce on the basis of an arbitrary number? The pilots to have the mandatory retirement age of 65, which aggravates the shortage of pilots in the United States.

Pilots and surgeons have a lot of responsibilities and keep lives in their hands. Errors and failures in judgment or skills can be fatal. What about other groups that make decisions about life and death? Let's look at Congress first.

the 115th Congress is "among the oldest in history". The average American is 20 years younger than his representative in Congress. Democratic leaders have two decades of development compared to their Republican counterparts, with an average leadership of 72 years and presidents and members of Democratic ranks aged 68, well beyond the age of pilot retirement.

Congress frequently makes decisions about life or death, such as authorizing and financing wars in Iraq and Afghanistan, where number of dead is high. About 7,000 US Army members, 8,000 American contractors and 360 journalists perished in these wars. Add to this the civilians and the opposition fighters, and the death toll rises to half a million. How old were those who allowed this war?

The members of Congress who voted for Obamacare made a vital decision for many people who lost their insurance or could no longer afford their medical care. Those who could not pay their deductible jumped to the doctor or hospital, with potentially fatal consequences.

People currently opposed to border security make deadly decisions for Americans who are victims of the consequences of illegal immigration, such as those injured or killed by illegal actions or the illicit drug pipeline crossing the border. border.

the short Supreme is also a group of seniors, consisting of six judges over the age of 60 and two others aged 80. Judge Ginsburg, 85 years old and suffering from a myriad of medical problems, is not the subject of any New York Times article questioning her jurisdiction to sit on the High Court. These nine judges, mostly seniors, make vital and moral decisions for millions of people.

Decisions on abortion have resulted in the deaths of tens of millions of babies. The second amendment's restrictions threaten the lives of those who try to defend themselves against bodily injury or death.

Why does age only concern surgeons and not government officials? How many policymakers in Washington may be too old to make vital or life-threatening decisions? Why do not they undergo a test of competence?

How old are the presidential hopes for 2020? Bernie Sanders is 77, Joe Biden 76, Elizabeth Warren 69. If they were pilots, they would have retired.

the congress pharmacy would have "filled prescriptions for" fairly serious health problems "for members of Congress, including drugs for Alzheimer's disease." The Speaker of the House of Representatives, Nancy Pelosi, third in the chair, is 78 years old. Some believe she suffers from senile dementia.

Would a surgeon of this age be allowed to operate? A surgeon may be subject to a proficiency test, but what about politicians? I suspect most voters do not know the age of their elected representatives. The urn is an ineffective way of assessing competence, as anyone who follows the news understands.

If it is in the public interest to evaluate the competence of surgeons, why not also evaluate those who occupy a prominent place in power and influence in Washington?

Brian C. Joondeph (@RetinalDoctor), MD, MPS, is a Denver-based physician.


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