The Aging Surgeon: Implications for the Workforce, the Surgeon, and the Patient.

Surgeons suffer from the same physiologic impairments common to all people with advancing age. These impairments not only affect the surgeon but also the patients under their care. This article delineates the epidemiologic context of the graying population of surgeons and the cognitive and physiologic changes that occur as the result of aging, the consequence of which is that greater experience does not necessarily equate with better clinical outcomes. This work also addresses potential methods for the ongoing evaluation of the aging surgeon and how elder surgeons may be best used as they reach the conclusion of their career.

[1]  T. John,et al.  Hepatitis B vaccine , 1999, Indian Pediatrics.

[2]  L. Burns,et al.  The Effects of Patient, Hospital, and Physician Characteristics on Length of Stay and Mortality , 1991, Medical care.

[3]  O. Jonasson,et al.  Retirement age and the work force in general surgery. , 1996, Annals of surgery.

[4]  M. Carty,et al.  The influence of volume and experience on individual surgical performance: a systematic review. , 2015, Annals of surgery.

[5]  S. Rhee.  Factors Determining the Quality of Physician Performance in Patient Care , 1976, Medical Care.

[6]  David S. Wang,et al.  Survey of urological laparoscopic practice patterns in the midwest. , 2004, The Journal of urology.

[7]  T. Athanasiou,et al.  Sleep deprivation leads to burnout and cardiothoracic surgeons have to deal with its consequences. , 2015, International journal of cardiology.

[8]  G. Mitchell,et al.  Doctors do not adequately look after their own physical health , 2004, The Medical journal of Australia.

[9]  D. Lanska,et al.  Surgeon characteristics associated with mortality and morbidity following carotid endarterectomy , 2000, Neurology.

[10]  L. Greenfield,et al.  When should a surgeon retire? , 1999, Advances in surgery.

[11]  M. Ritter,et al.  Retirement from orthopaedic surgery. , 1999, Journal of Bone and Joint Surgery. American volume.

[12]  M. Ritter,et al.  Current Concepts Review - Retirement from Orthopaedic Surgery* , 1999 .

[13]  R. Rovit.  To everything there is a season and a time to every purpose: retirement and the neurosurgeon. , 2004, Journal of neurosurgery.

[14]  R. Ihl,et al.  Differential validity of psychometric tests in dementia of the Alzheimer type , 1992, Psychiatry Research.

[15]  N. Voirin,et al.  Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study , 2012, BMJ : British Medical Journal.

[16]  L Lasagna,et al.  The Relationship between Physician Characteristics and Prescribing Appropriateness , 1972, Medical care.

[17]  J. Avorn,et al.  Influence of clinical knowledge, organizational context, and practice style on transfusion decision making. Implications for practice change strategies. , 1990, JAMA.

[18]  S. Miller,et al.  Systematic Review: The Relationship Between Clinical Experience and Quality of Health Care , 2006 .

[19]  C. Peisah,et al.  Medical masters: A pilot study of adaptive ageing in physicians , 2009, Australasian journal on ageing.

[20]  R. Cattell.  Theory of fluid and crystallized intelligence: A critical experiment. , 1963 .

[21]  J. Trollor,et al.  Brain Ageing in the New Millennium , 2001, The Australian and New Zealand journal of psychiatry.

[22]  D. Trunkey,et al.  Assessing competency: a tale of two professions. , 2001, Journal of the American College of Surgeons.

[23]  B. Waxman,et al.  Adaptive ageing surgeons , 2014, ANZ journal of surgery.

[24]  R. Adler,et al.  Knowing — or not knowing — when to stop: cognitive decline in ageing doctors , 2008, The Medical journal of Australia.

[25]  J. Freischlag,et al.  Burnout and Career Satisfaction Among American Surgeons , 2009, Annals of surgery.

[26]  R. Rainsbury,et al.  Breast reconstruction in the United Kingdom and Ireland , 2002, The British journal of surgery.

[27]  Stephen Lock,et al.  William Osler: A Life in Medicine , 2000, BMJ : British Medical Journal.

[28]  D. Heck,et al.  Patient Outcomes After Knee Replacement , 1998, Clinical orthopaedics and related research.

[29]  A. Schuricht,et al.  The Role of Laparoscopy in the Management of Groin Hernia , 1998, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[30]  C. Peisah,et al.  The greying intensivist: ageing and medical practice — everyone's problem , 2012, The Medical journal of Australia.

[31]  Joseph A Hill.  United States Life Tables , 2013 .

[32]  ACS survey explores retirement and the surgeon. , 1996 .

[34]  D. Lawrence,et al.  National Mental Health Survey of Doctors and Medical Students , 2013 .

[35]  A. Kaluzny,et al.  Preferences of Community Physicians for Cancer Screening Guidelines , 1994, Annals of Internal Medicine.

[36]  J. W. Humphreys,et al.  Recertification in surgery, 1980. , 1981, Archives of surgery.

[37]  B. Virshup,et al.  Physicians' adjustment to retirement. , 1993, The Western journal of medicine.

[38]  R. Shaban,et al.  ‘The Australian Immunisation Handbook 8th Edition’. National Health and Medical Research Council, Australian Government. Canberra: Commonwealth of Australia; 2003. 350 pages, ISBN 0-642-82204-2 , 2015 .

[39]  H. Dimassi,et al.  Disciplinary action against physicians: who is likely to get disciplined? , 2005, The American journal of medicine.

[40]  L. Temple,et al.  Maintenance of Certification: What Everyone Needs to Know , 2015, Annals of Surgical Oncology.

[41]  Alice Owen,et al.  The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model , 2012, BMJ : British Medical Journal.

[42]  The retired surgeon: a potential teaching resource. , 1997, Annals of the Royal College of Surgeons of England.

[43]  Justin B Dimick,et al.  Surgeon Age and Operative Mortality in the United States , 2006, Annals of surgery.

[44]  K. Wilhelm,et al.  Physician don't heal thyself: a descriptive study of impaired older doctors , 2007, International Psychogeriatrics.

[45]  E. Kuhn,et al.  Prestige of training programs and experience of bypass surgeons as factors in adjusted patient mortality rates. , 1999, Medical care.

[46]  R. Blasier.  The Problem of the Aging Surgeon: When Surgeon Age Becomes a Surgical Risk Factor , 2009, Clinical orthopaedics and related research.

[47]  A. Unsal,et al.  Competence and Cognitive Difficulty in Physicians: A Follow-up Study , 2006, Academic medicine : journal of the Association of American Medical Colleges.

[48]  ACS survey explores retirement and the surgeon. , 1996, Bulletin of the American College of Surgeons.

[49]  M. Katlic,et al.  The Aging Surgeon. , 2016, Advances in surgery.

[50]  Thomas Pasko,et al.  Physician Characteristics and Distribution in the Us: 1999 , 1998 .

[51]  E. Arias.  United States life tables, 2010. , 2014, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[52]  The retired surgeon: a potential teaching resource. , 1997 .

[53]  J. Margenthaler,et al.  Evaluation of patients with clinically suspected melanoma recurrence: current practice patterns of plastic surgeons. , 2002, International journal of oncology.

[54]  C. Peisah,et al.  The impaired ageing doctor , 2002, Internal medicine journal.

[55]  A. Park,et al.  Patients benefit while surgeons suffer: an impending epidemic. , 2010, Journal of the American College of Surgeons.

[56]  Brian Draper,et al.  THE OLDER PSYCHIATRIST AND RETIREMENT , 1997, International journal of geriatric psychiatry.

[57]  A. Gawande,et al.  Proficiency of Surgeons in Inguinal Hernia Repair: Effect of Experience and Age , 2005, Annals of surgery.

[58]  L. Greenfield,et al.  Cognitive changes and retirement among senior surgeons (CCRASS): results from the CCRASS Study. , 2008, Journal of the American College of Surgeons.