If doctors need competency testing, so do politicians

Medical doctors are becoming victims of age discrimination in Las Vegas.

So asserts Dr. Dale Carrison, the 77-year-old chief of staff at University Medical Center and the hospital’s head of emergency medicine.

Carrison is referring specifically to a Healthcare Partners of Nevada policy that makes doctors 70 or older complete an annual physical and mental health examination to ensure they’re still able to practice medicine. It is the kind of policy increasingly being adopted by U.S. medical groups and hospitals concerned about liability.

“It is blatant age discrimination,” Carrison says. “You have to look at each doctor individually.”

He said that regardless of a doctor’s age, if his practice changes — he becomes forgetful, has complications in his work or misspeaks, say, in assessments — there should be an intervention and a doctor review. He noted that doctors already have peer review, continuing education and maintenance of certification to ensure they’re performing professionally.

David Tauchen, a spokesman for Healthcare Partners, won’t talk about his group’s recently enacted policy.

“We don’t share internal policies externally, but our physicians’ performance is regularly reviewed,” he said.

The Valley Health System requires doctors older than 70 to have an annual physical. The Sunrise Health System won’t disclose its policy.

Carrison gave me copies of documents Healthcare Partners wants him to have filled out by an independent physician who examines him. If he doesn’t, he can’t be credentialed, meaning he can’t see the group’s patients and be reimbursed at an urgent care where he would like to fill in for practitioners in his emergency medical organization.

The mental health exam includes the following requirements: “Have the patient write a sentence. It must contain a subject and a verb”… ”Have patient repeat the following: ‘No ifs, ands, or buts’”… “What is the year, season, date, day, month”… “Show objects and ask patient to name: Pen/Pencil, Watch/Clock.”

Because Carrison refuses on principle to engage “in this stupidity that does nothing to review whether a doctor is competent,” he can’t be reimbursed for seeing Healthcare Partners’ patients at the urgent care. But Healthcare Partners is comfortable with him seeing their far sicker patients in the UMC emergency room, which does not routinely screen physicians for age-related physical or mental slippage.

“It makes no sense,” he said. “It’s bizarre.”

Carrison’s frustration with mandatory competency testing for aging doctors — more that one quarter of physicians in the U.S. are 60 or older — first became known publicly during the recent Las Vegas Heals gala at the Four Seasons, where he was one of five physicians honored for contributions to medicine in Southern Nevada.

Although his award acceptance remarks included his belief that patients can find superb medical care here in Southern Nevada, no outbound airplane trip required, he added: “If there’s anybody here from Healthcare Partners of Nevada, I hope this (talk) counts as my mental status examination.”

The American Medical Association is studying whether mandatory competency for aging doctors should be required. An article in this month’s AMA Journal of Ethics by Dr. Krista Kaups noted mandatory age-linked testing has “raised questions regarding age discrimination and test validity … competence not age determines ability to practice.”

Writing last year in the American Thinker, Dr. Brian Joondeph argued that politicians have lives in their hands just as physicians do. Their decision to go into Iraq, for example, cost the lives of 6,800 American troops, he added, yet the idea of mandatory competency testing for members of the U.S. Senate, where the percentage of seniors is greater than among physicians, never comes up.

Nor does it come up for presidential candidates, who could one day push the button that ends the world. Hillary Clinton had a concussion she admits made her forgetful. Donald Trump’s father died of Alzheimer’s disease, which frequently runs in the family.

Joondeph’s right: If physicians need an independent evaluation of mental and physical health to demonstrate competency, shouldn’t the candidates we’re voting on today for the highest office in the land have been held to a similar standard?

Paul Harasim’s column runs Sunday, Tuesday and Friday in the Nevada section and Monday in the Health section. Contact him at pharasim@reviewjournal.com or 702-387-5273. Follow @paulharasim on Twitter