Since 2015, when Sinai Hospital in Baltimore, MD, inaugurated a screening program for surgeons over 75, about 30 from around the country have undergone its comprehensive two-day physical and cognitive assessment. Dr. Mark Katlic, director of the Aging Surgeon Program, evaluated a surgical oncologist, who “did not come of his own accord.” But he came.  The tests revealed mild cognitive impairment, often but not necessarily a precursor to dementia. The neuropsychologist’s report advised that the surgeon’s difficulties were “likely to impact his ability to practice medicine as he is doing presently, e.g. conducting complex surgical procedures.”

That didn’t mean the surgeon had to retire; a variety of accommodations would allow him to continue in other roles. “He retained a lifetime of knowledge that had not been impacted by cognitive changes,” Dr. Katlic said. The hospital “took him out of the O.R., but he continued to see patients in the clinic.”

Such incidents are likely to become more common, because America’s physician work force is aging fast. In 2005, more than 11 percent of doctors who were seeing patients were 65 or older, the American Medical Association said. Last year, the proportion reached 22.4 percent, nearly 203,000 older practitioners.

Given physician shortages, especially in rural areas and in key specialties like primary care, nobody wants to drive out veteran doctors with skills and experience.

Yet researchers have documented “a gradual decline in physicians’ cognitive abilities starting in their mid-60s,” said Dr. Thomas Gallagher, an internist and bioethicist at the University of Washington who has studied late-career trajectories. At older ages, reaction times slow; knowledge can become outdated. Cognitive scores vary greatly, however. “Some practitioners continue to do as well as they did in their 40s and 50s, and others really start to struggle,” Dr. Gallagher said.

A few health organizations have responded by establishing late-career practitioner programs mandating that older doctors be screened for cognitive and physical deficits. Nobody has tracked how many exist; Dr. Gallagher guesstimated as many as 200. But given that the United States has more than 6,000 hospitals, those with late-career programs constitute “a vast minority,” he said.

“There are all sorts of accommodations” for doctors whose assessments indicate the need for different roles, Dr. Gallagher noted. They could adopt less onerous schedules or handle routine procedures while leaving complex six-hour surgeries to their colleagues. They might transition to teaching, mentoring and consulting.

Yet a substantial number of older doctors head for the exits and retire rather than face a mandated evaluation, he said.

This article advises, “If you see something, say something,” referring to health care professionals who witness doctors (of any age) faltering.

BUT what if you notice something? What would you do? Who would you talk to about your concerns?

Here is the link to the original article, https://www.nytimes.com/2026/01/31/health/doctors-cognitive-decline.html, which may require a subscription.