Cargando…

The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons

BACKGROUND: Unlike some other safety critical professions, there is no mandatory age of retirement for doctors, including surgeons. Medical regulators in Australia are implementing additional checks on doctors from the age of 70. We describe expert opinions on assuring performance and supporting car...

Descripción completa

Detalles Bibliográficos
Autores principales: Sherwood, Rupert, Bismark, Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045790/
https://www.ncbi.nlm.nih.gov/pubmed/31363015
http://dx.doi.org/10.1136/bmjqs-2019-009596
_version_ 1783501846501916672
author Sherwood, Rupert
Bismark, Marie
author_facet Sherwood, Rupert
Bismark, Marie
author_sort Sherwood, Rupert
collection PubMed
description BACKGROUND: Unlike some other safety critical professions, there is no mandatory age of retirement for doctors, including surgeons. Medical regulators in Australia are implementing additional checks on doctors from the age of 70. We describe expert opinions on assuring performance and supporting career transitions among older surgeons. METHODS: In this qualitative study, experts in four countries were purposively selected for their expertise in surgical governance. Experts responded to interviews (Australia, New Zealand and UK) or a survey (Canada). A tiered framework of interventions was developed by integrating findings with previous literature and responsive regulation theory. RESULTS: 52 experts participated. Participants valued the contribution of senior surgeons, while acknowledging that age-related changes can affect performance. Participants perceived that identity, relationships and finances influence retirement decisions. Experts were divided on the need for age-specific testing, with some favouring whole-of-career approaches to assuring safe care. A lack of validated tools for assessing performance of older surgeons was highlighted. Participants identified three options for addressing performance concerns—remediate, restrict or retire—and emphasised the need for co-ordinated and timely responses. CONCLUSION: Experts perceive the need for a staged approach to assessing the performance of older surgeons and tailoring interventions. Most older surgeons are seen to make decisions around career transitions with self-awareness and concern for patient safety. Some older surgeons may benefit from additional guidance and support from employers and professional colleges. A few poorly performing older surgeons, who are recalcitrant or lack insight, require regulatory action to protect patient safety. Developing robust processes to assess performance, remediate deficits and adjust scopes of practice could help to support safe career transitions at any age.
format Online
Article
Text
id pubmed-7045790
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-70457902020-03-09 The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons Sherwood, Rupert Bismark, Marie BMJ Qual Saf Original Research BACKGROUND: Unlike some other safety critical professions, there is no mandatory age of retirement for doctors, including surgeons. Medical regulators in Australia are implementing additional checks on doctors from the age of 70. We describe expert opinions on assuring performance and supporting career transitions among older surgeons. METHODS: In this qualitative study, experts in four countries were purposively selected for their expertise in surgical governance. Experts responded to interviews (Australia, New Zealand and UK) or a survey (Canada). A tiered framework of interventions was developed by integrating findings with previous literature and responsive regulation theory. RESULTS: 52 experts participated. Participants valued the contribution of senior surgeons, while acknowledging that age-related changes can affect performance. Participants perceived that identity, relationships and finances influence retirement decisions. Experts were divided on the need for age-specific testing, with some favouring whole-of-career approaches to assuring safe care. A lack of validated tools for assessing performance of older surgeons was highlighted. Participants identified three options for addressing performance concerns—remediate, restrict or retire—and emphasised the need for co-ordinated and timely responses. CONCLUSION: Experts perceive the need for a staged approach to assessing the performance of older surgeons and tailoring interventions. Most older surgeons are seen to make decisions around career transitions with self-awareness and concern for patient safety. Some older surgeons may benefit from additional guidance and support from employers and professional colleges. A few poorly performing older surgeons, who are recalcitrant or lack insight, require regulatory action to protect patient safety. Developing robust processes to assess performance, remediate deficits and adjust scopes of practice could help to support safe career transitions at any age. BMJ Publishing Group 2020-02 2019-07-30 /pmc/articles/PMC7045790/ /pubmed/31363015 http://dx.doi.org/10.1136/bmjqs-2019-009596 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Original Research
Sherwood, Rupert
Bismark, Marie
The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons
title The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons
title_full The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons
title_fullStr The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons
title_full_unstemmed The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons
title_short The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons
title_sort ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045790/
https://www.ncbi.nlm.nih.gov/pubmed/31363015
http://dx.doi.org/10.1136/bmjqs-2019-009596
work_keys_str_mv AT sherwoodrupert theageingsurgeonaqualitativestudyofexpertopinionsonassuringperformanceandsupportingsafecareertransitionsamongoldersurgeons
AT bismarkmarie theageingsurgeonaqualitativestudyofexpertopinionsonassuringperformanceandsupportingsafecareertransitionsamongoldersurgeons
AT sherwoodrupert ageingsurgeonaqualitativestudyofexpertopinionsonassuringperformanceandsupportingsafecareertransitionsamongoldersurgeons
AT bismarkmarie ageingsurgeonaqualitativestudyofexpertopinionsonassuringperformanceandsupportingsafecareertransitionsamongoldersurgeons