Sunday, August 15, 2010

How Old Is Too Old in Medicine?

With apologies to the Beatles...
When I get older, losing my hair, many years from now, ...
Will you see need me, will you still feed me...
...when I'm ninety-four:
Former NYPD chief cardiologist Dr. Irving Kroop retired in 1986 -- when he was 70 -- with a $64,364 disability pension awarded because of a bad heart, according to sources and city records.

All the while, he's maintained a private practice in Brooklyn and moonlighted at NYCERS, the New York City Employees Retirement System, which paid him $14,479 last year to help determine whether other city workers should get disability pensions.

Hats off to the man -- he's 94 years old but disabled? And still going strong?" said an incredulous Carol Kellerman, head of the Citizens Budget Commission.

Kroop, who gets $155 an hour as a private contractor for city's civilian pension board, shuffles into examining rooms with a cane and oxygen tank, sources say.
This story presents an interesting dilemma in this era of shrinking retirement income for our seniors who want to continue to work.

Should there be an age limit for practicing doctors? How do we assess if a doctor is "disabled" as they age? Should we care? Should cardiologists performing physical examinations at an advanced age have, say, an annual hearing and vision test to assure they can still hear heart sounds or see jugulovenous distension?

Or is the ability to walk into an exam room with a cane (rather than a walker) while wearing oxygen enough to certify them capable to practice medicine?


PS: 94's chump change. How about 100 and still practicing?
(h/t @DrDeanBurke on Twitter)


Dr Dean said...

Check out this newspaper article about Curly Watson MD, an Ob still practicing at a cool 100!

We thought he was old, when I was a SMS back in 1980.

Beryl said...

Good morning
speaking from a patients point of view my own cardiologist told me some months ago he is going with early retirement ,
he is 58. How does a patient cope?

Dr Nayana Somaratna said...

I've always thought that a clinician only starts properly understanding his field in his 40s and only becomes a true expert in his 50s and 60s.

The retirement age here in Sri Lanka is 60 years, which in my opinion is a bit too young. 60 is the age where a doctor is experienced enough to diagnose patients easily, but also where his physical skills have not deteriorated significantly.

As for beyond that ? It depends a lot - I've seen a surgeon aged 99 years old do a thyroidectomy (and walk without a cane !).

I guess that most of us tend to age well - assuming that a stroke or MI does not cause morbidity, we can continue working well in our 70s or 80s (and face it, as Doctors, we *need* to work - leisurely retirement would be oh, so boring !)