Abstract

This book chapter examines the growing challenge of cognitive decline among aging physicians and analyzes various approaches to addressing it. In 2024, twenty percent of working physicians were sixty-five or older, and evidence suggests that 12-14% of older clinicians have cognitive deficits that may affect job performance. The chapter evaluates two primary approaches to cognitive assessment: employer-initiated programs and programs operated by state medical boards. Employer "late career practitioner policies" (LCPP) that require older physicians to undergo testing are becoming increasingly popular among health care organizations. But they are vulnerable to challenge under disability and age discrimination laws, as evidenced by an ongoing Equal Employment Opportunity Commission lawsuit against Yale New Haven Hospital. Consequently, state medical boards are likely better positioned to implement cognitive assessment requirements. The chapter provides specific recommendations for both employer- based and state board testing programs. It emphasizes the importance of using validated assessment tools, providing due process, and offering reasonable accommodations when possible. The problem of unidentified cognitive decline among physicians has been characterized as a "looming public health crisis of aging physicians." It can no longer be ignored and requires urgent and thoughtful interventions.

Keywords

cognitive decline, physician workforce, late career practitioner policies, neuropsychological testing, medical licensing boards, age discrimination, disability discrimination, employment discrimination, cognitive assessment, physician competency

Publication Date

2027

Document Type

Article

Publication Information

“Addressing the Challenges of Cognitive Decline in the Physician Workforce” in LAW, HEALTH CARE, AND THE AGING BRAIN AND BODY (I. Glenn Cohen, Francis Shen, Nina A. Kohn, and Susannah Baruch eds., Cambridge University Press, forthcoming 2027)

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COinS Sharona Hoffman Faculty Bio