Abstract
The importance and variety of the many decisions which practicing operative surgeons are obliged to make throughout their career is discussed, together with the multiple factors which may influence those decisions, and to what extent those factors are adversely affected as the surgeon’s age. Since the 1986 legislation against age discrimination, there are no uniformly accepted regulations or guidelines for determining when surgeons should quit operating. Studies to justify rules or recommendations for retirement from active major surgical operative and patient management have addressed this issue increasingly during the past five decades, but have not yet produced definitive answers to the question. Safety and competency do not correlate uniformly with age, and currently the decision has been largely left to the discretion of the surgeon. Efforts to examine surgeons objectively for cognitive and technical skills and proficiency, eyesight, eye–hand coordination, strength, endurance, and other indices that might validate the safety, efficacy, competence, judgment, and wisdom of the surgeon have not been embraced to date by the surgical community, but are beginning to gain support from professional societies, governing and credentialing bodies, hospitals, and other healthcare institutions. Resolution of the multiple complex issues which must occur to solve this vexing problem and to answer this important question, which is critical both to patients and to the surgeons, is forthcoming.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
Used with permissions from Greenfield LJ. “Farewell to Surgery.” Presented as the Presidential Address at the Forty-first Scientific Meeting of the International Society for Cardiovascular Surgery, North American Chapter, Washington, D.C., June 7–8, 1993. J Vasc Surg 1994;19:6–14.
- 2.
Used with permission from Greenfield LJ. “Farewell to Surgery .” Presented as the Presidential Address at the Forty-first Scientific Meeting of the International Society for Cardiovascular Surgery , North American Chapter, Washington, D.C., June 7–8, 1993. J Vasc Surg 1994;19:6–14.
- 3.
Used with permission from Katlic MR, Coleman J. The Aging Surgeon. Annals of Surgery 2014;260 (2):199–201.
- 4.
Used with permission from Whitehead N. http://www.npr.org/sections/health-shots/2015/06/18/414912417/when-should-surgeons-stop-operating.
- 5.
Used with permission from Whitehead N. http://www.npr.org/sections/health-shots/2015/06/18/414912417/when-should-surgeons-stop-operating.
References
Pogo KW. Daily comic strip. Earth day. New York: Post-Hall Syndicate, Simon & Schuster; 1971.
Bradley R, Nehra M, Nehra A, Folkes J. The Gambler. Sony/ATV Music Publishing, LLC; 1978.
Greenfield LJ. “Farewell to surgery”. Presented as the presidential address at the forty-first scientific meeting of the international society for cardiovascular surgery, North American Chapter, Washington, DC, june 7–8, 1993. J Vasc Surg. 1994;19:6–14.
Stauger R. Boredom on the assembly line: age and personality variables. Industr Geront. 1975;30:23–43.
Benson R. Management perceptions of older employees. Mon Labor Rev. 1978;101:33–5.
Hauon engineering guide to equipment design. New York: McGraw Hill; 1963.
Garg A, Funke S, Janisch D. One-handed dynamic pulling strength with special applications to lawn mowers. Ergonomics. 1988;31:1139–53.
Astrand PO, Rodahl K. Textbook of work physiology. New York: McGraw Hill; 1977.
Tzankoff SP. Age-related differences in lactase distribution kinetics following maximal exercise. Eur J Appl Physiol. 1979;42:35–40.
Karnes EW, Freeman A, Whalen J. Engineering work standards for warehouse operations: effects of performance ratings, age, gender and neglected variables. In: Trends in ergonomics/human factors III (part A). New York: Elsevier Science/North Holland; 1986. p. 535–43.
Welford AT. Changes of performance with age: an overview. In: Aging and human performance. New York: Wiley; 1985. p. 333–65.
Required quantity and quality of light committee. Selection of illuminance values for interior lighting design (RQQ report 6). J Illum Eng Soc. 1980;9:188–90.
Garg A. Ergonomics and the older worker: an overview. Exp Aging Res. 1971;17:143–55.
Partyka S. Comparison by age of drivers in two-car fatal crashes. National highway traffic safety administration. Washington, DC: U.S. Department of Transportation; 1983.
Waller PF. Renew licensing of older drivers. Transportation in an aging society, vol. 2. Washington, DC: Transportation Research Board, National Research Council; 1988. Special report No. 218 72–100.
Powell DH, Whitla D. Profiles in cognitive aging. Cambridge: Harvard Press; 1994.
Thorwald J. The dismissal: the last days of Ferdinand Sauerbruch. New York: Pantheon; 1962.
Deckert GH. How to retire happy. Med Econ. 1992;69:73–80.
Neumayer LA, Gawande AA, Wang J, Giobbie-Hurder MS, Itani KMF, Fitzgibbons Jr RJ. Proficiency of surgeons in inguinal hernia repair: effect of experience and age. Ann Surg. 2005;242:344–8. discussion 348–352.
Waljee JF, Greenfield LJ, Dimick JB, Birkmeyer JD. Surgeon age and operative mortality in the United States. Ann Surg. 2006;244:353–62.
Bieliauskas LA, Langenecker S, Graver C, Jin Lee H, O’Neill J, Greenfield LJ. Cognitive changes and retirement among senior surgeons (CCRASS): results from the CCRASS Study. J Am Coll Surg. 2008;207:69–78. discussion 78–79.
Boom-Saad Z, Langenecker SA, Bieliauskas LA, Graver CJ, O’Neill J, Caveney AF. Surgeons outperform normative controls on neuropsychologic tests, but age-related decay of skills persist. Am J Surg. 2008;195:205–9.
Blasier RB. The problem of the aging surgeon. Clin Orthop Relat Res. 2009;467:402–11.
Tuwairqi K, Selter JH, Sikder S. Assessment of surgeon fatigue by surgical simulators. Open Access Surg. 2015;8:43–50.
Garrett K, Kaups KL. The aging surgeon: when is it time to leave active practice? American College of Surgeons: Bulletin; 2014.
Drag LL, Bieliauskas LA, Langenecker SA, Greenfield LJ. Cognitive functioning, retirement status, and age: results from the cognitive changes and retirement among senior surgeons study. J Am Coll Surg. 2010;211:303–7.
Whitehead N. http://www.npr.org/sections/health-shots/2015/06/18/414912417/when-should-surgeons-stop-operating.
Katlic MR, Coleman J. The aging surgeon. Ann Surg. 2014;260(2):199–201.
Perry PR. Governors’ committee on physician competency and health. Bulletin, American College of Surgeons. May 2013.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Dudrick, S.J. (2016). When Should Surgeons Quit Operating?. In: Surgical Decision Making. Springer, Cham. https://doi.org/10.1007/978-3-319-29824-5_23
Download citation
DOI: https://doi.org/10.1007/978-3-319-29824-5_23
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-29822-1
Online ISBN: 978-3-319-29824-5
eBook Packages: MedicineMedicine (R0)