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Special Communication
May 15, 2019

Transition Planning for the Senior Surgeon: Guidance and Recommendations From the Society of Surgical Chairs

Author Affiliations
  • 1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
  • 2Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 3Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 4Departments of Surgery and Biomedical Engineering, University of North Carolina, Chapel Hill
  • 5Editor, JAMA Surgery
  • 6Department of Surgery, Rutgers New Jersey Medical School, Newark
JAMA Surg. Published online May 15, 2019. doi:10.1001/jamasurg.2019.1159
Abstract

Importance  Aging is well documented to be associated with declines in cognitive function and psychomotor performance, but only limited guidance is currently available from medical professional societies or regulatory agencies on how to translate these observations into the appropriate monitoring of physician performance.

Observations  The Society of Surgical Chairs conducted a panel discussion at its 2017 annual meeting and a subsequent survey of its membership in 2018 to develop recommendations for the transitioning of the senior surgeon.

Conclusions and Relevance  Recommendations include mandatory cognitive and psychomotor testing of surgeons by at least age 65 years, potentially as a component of ongoing professional practice evaluation; career transition discussions with surgeons beginning early in their careers; respectful consideration of the potential financial needs, long-standing work commitments, and work-life concerns of retiring surgeons; and creation of teaching, mentoring or coaching, and/or administrative opportunities for senior surgeons in modified clinical or nonclinical roles. Ideally, these initiatives will catalyze a thoughtful and comprehensive new vista in supporting an aging workforce while ensuring the safety of patients, the efficient management of health care organizations, and the avoidance of unnecessary depletions to a sufficiently sized cadre of physicians with case-specific competencies.

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