Which assessment strategy does the GP community prefer? Health checks with peers more palatable than specialist-led alternative…

Following a snap poll of GPs who attended Healthed’s Women’s and Children’s Health Update last month, we surveyed more than 1600 GPs after out latest fortnightly webcast to see how a larger and more gender-balanced demographic feels about the Medical Board’s proposed solutions to the disproportionate number of complaints levelled against doctors aged 70 or older.

With the Medical Board’s consultation process underway, we put the three options they are seeking input on directly to GPs:

• Keep the status quo and do nothing extra to ensure late career doctors are healthy and able to provide safe care
• Introduce an extensive and detailed ‘fitness to practise’ assessment for all doctors aged 70 and older, to be conducted by specialist occupational physicians, or
• Introduce general health checks with a GP for late career doctors aged 70 and older, to support early detection of concerns with the opportunity for management before the public is at risk.

When we asked GPs which option was most appropriate, 50% agreed with the Board’s preferred choice of requiring general health checks with their peers, while 9% supported extensive assessments by a specialist and 41% felt nothing extra needed to be done to ensure safe care.

Like the snap poll, the larger follow-up survey shows a divide between older and younger GPs. Again, we found that the older GPs were, the more likely they were to support keeping the status quo, while the younger they were, the more likely they were to support interventions.

Even GPs who aren’t keen on assessments overall much prefer peer-led health checks over specialist-led assessments.

When we asked how strongly GPs agreed or disagreed with the proposal to require mandatory health checks by their peers, 47% agreed, 20% were neutral and 33% disagreed.

While there were fewer GPs in the oldest and youngest cohorts, they had the most polarised views. GPs aged 35-54 were much more likely to agree with GP-led mandatory health checks for doctors aged 70 and up. And on the flip side, doctors aged 65 and over were more likely to disagree with them than their younger colleagues.

How can we better support late-career doctors to stay safe in practice?

We also asked what else could be done to support late-career doctors to stay safe in practice. About one quarter of the 800 free text responses we received suggested some form of health assessment to ensure fitness to practice, while others highlighted the importance of peer support and mental health support, as well as peer review and monitoring and strategies to reduce pressure on ageing GPs. More than 20% strongly opposed any extra measures, instead favouring the status quo.

Here’s what GPs in our survey are suggesting.

Changes to facilitate peer review

Several GPs suggested that late-career doctors should be encouraged to work in group practices, with some suggesting additional assessments for those working solo.

• “Offer opportunities for older doctors to mentor younger colleagues, which can also serve as a way to monitor their fitness to practice.”
• “Encourage older doctors to work in group practices where peers can provide oversight and support.”
• “Implement a system where older doctors have regular peer reviews to ensure they are still competent to practice.”
• “Ensure that older doctors are not practicing in isolation but have regular interaction with colleagues who can offer guidance and monitor their performance.”

Strategies to ease the pressure

Others suggested encouraging older doctors to reduce their workload, retire earlier and transition to part time or advisory roles as they age.

• “Older doctors should be encouraged to retire earlier or reduce their workload to prevent burnout and ensure patient safety.”
• “Introduce a policy for gradual reduction in workload for doctors over 70, leading up to retirement.”
• “Doctors should be supported to transition into part-time or advisory roles as they age.”
• “Pay GPs better early in their career so they can afford to retire earlier.”
• “Better availability of locum doctors and increased rebates to allow older doctors to work reduced hours and have more time for educational activities.  Regular education catch up materials.”
• “Encourage them to continue working by removing the onerous new CPD requirements.”

Support and Encouragement

Many surveyed GPs suggested ways late-career doctors could be better supported.

• “Provide additional support to older doctors, such as mental health services and peer support, to help them manage the demands of the profession.”
• “They have to have an environment where they can seek help when needed without prejudice.”
• “Encourage older doctors to continue practicing by offering support and not creating unnecessary hurdles.
• “Have a mentorship program the way registrars have a mentor, so that cases and concerns can be discussed.”

Health assessments

Some GPs felt these should be mandatory, while others thought they should be encouraged through policy.

• “Incentive to see own GP and subsidy for healthcare costs”
• “General health checks every 3 years.”
• “Encourage all GPs to have their own GP”
• “General and mental health checks and ongoing support.”

Opposition to extra measures

Others were adamant that the current system is adequate to ensure safety.

• “There is no need for additional health checks for older doctors; they should be treated the same as their younger counterparts.”
• “The current CPD requirements are sufficient to ensure that all doctors, regardless of age, are competent to practice.”
• “Older doctors should not be subjected to discriminatory practices based on age; they have the experience and knowledge to continue practicing safely.”
• “CPD activities should be enough to ensure older doctors are practicing safely; no additional checks are needed.”