Should older doctors be forced to get check-ups?
The regulator wants public feedback on mandatory health assessments for GPs over 70. You can have your say.
Focus on seniors in the workforce
Age discrimination in the workforce is an important and complex issue.
National Seniors Australia has long advocated on behalf of older people who want or need to work beyond their retirement age. You can read about some of our work here.
The Australian Human Rights Commission has a fact sheet on age discrimination here.
A dramatic increase in public complaints about older doctors has led to the medical licensing body supporting mandatory health checks for GPs over 70.
That, combined with studies of neurocognitive loss, leading to poor record-keeping, improper prescribing, and even disruptive behaviour, has resulted in the Medical Board of Australia deciding to consult on three regulatory options to ensure patient safety.
These are:
Keeping the status quo and doing nothing extra to ensure late career doctors are healthy and able to provide safe care
Introducing an extensive and detailed “fitness to practise” assessment for all doctors aged 70 and older, to be conducted by specialist occupational physicians
Introduction of general health checks with another GP for doctors aged 70 and older, to support early detection of concerns with the opportunity for management before the public is put at risk.
The board favours the third option, which would require doctors 70 and older to undergo general health checks with another doctor every three years, and annually from 80.
Currently, as part of their professional code of conduct, doctors must seek independent medical and psychological care to prevent harming themselves and their patients.
The board’s support for intervention has raised questions about ageism, given that oversight based on age for other professionals, including judges, has met with pushback.
However, unlike judges, doctors are already required to renew their registration annually. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but also to assess their eligibility regularly and to conduct performance assessments as needed.
These proposals interact with Commonwealth anti-discrimination laws that have yet to be tested.
The federal age discrimination statute allows “qualifying bodies” such as the Medical Board to discriminate against an older professional who is “unable to carry out the inherent requirements of the profession, trade, or occupation because of his or her age”.
Legal experts say a license to practise medicine is comparable to a license to drive or pilot an aircraft. Despite claims of discrimination, New South Wales law requires older drivers to undergo a medical assessment every year, and similar requirements affect older pilots and air traffic controllers.
The Medical Board of Australia is keen to hear what doctors, patients, and the wider health sector think about these options. Public comment is open until 4 October.
In 2022–2023, the board took disciplinary action against older doctors about 1.7 times more often than for doctors under 70.
In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical board of Australia about older doctors – up from 189 in 2015.
Older doctors make up only about 5.3% of the doctor workforce (less than 1% are over 80), which further highlights the disproportionate high numbers of complaints.
The rate of complaints almost doubled over the past eight years, rising from 36.2 notifications per 1,000 practitioners aged 70 and older in 2015, to 69.5 complaints per 1,000 in 2023.
The board says complaints against doctors in the 70-74 year age bracket have “jumped disturbingly”, from 32 complaints per 1,000 doctors in 2015, to more than 74 complaints per 1,000 in 2023.
In comparison, notifications about doctors aged under 70 have increased from 23.4 to 38.3 per 1,000 over the same period.
Board chair, Dr Anne Tonkin AO, said measures for earlier identification of issues earlier that may impact a doctor’s practice could prevent future patient harm and provide opportunities for practitioners to take action to extend their careers.
“Doctors are often reluctant patients, and we are concerned they don’t always seek the care they need,” she said.
“We’re looking for a way to keep late career doctors in charge of their career. By having regular general health checks from age 70, late career doctors and their treating practitioners will be able to make informed decisions about how they practise, and when they retire.”
Results of general health checks would be confidential, and the board would only be informed if a treating practitioner made a mandatory report about a late career doctor who refused to manage the risk to patients caused by ill health.
Related reading: Medical Board 1, Medical Board 2, Public comment
