Who cares if they want to retire? Let them go. Being a doctor is lifetime learning, you don’t get to just shut it off because you’re old. If you want to do that, then retire.
so now having been in practice for a long time and have had a chance to see how decisions get made in 3 reasonably sized organizations. i can’t tell you how many times a new policy or rule is developed and someone asks well what about dr. x who has been doing this for 30 years. so a grandfather clause is made with the expectation that time will solve the problem and avoid prematurely ending someone’s career or practice pattern or whatever.
question for discussion is- how do we feel about grandfathering? is it something with nuance or just plain wrong and policies should be developed with blind eye toward how it affects specific individuals. for the sake of our discussion, which hopefully will remain civil, let’s just talk about medical policies, rather government or other stuff. eventually, if lucky, we will all be on the other side of the slope, and no longer specifically trained in procedure x or surgery y. is everything going to be like ACLS? take some computer class to authenticate your diabetes management?
thanks for any thoughtful comments.
COUNTERPOINT: a new grad has 30-40 future yrs to give to the practice and specialty, so they should have more voting power on policies than a grandfathered doc with one foot out the exit. Yes there is a nuanced discussion to be had about the out of date physician, but we should not be handing out golden parachutes. I also reject the argument that too many docs would retire without grandfathering leading to a shortage, those in academia know we have a surplus of med school grads now and the bottleneck is that we do not have enough residencies/fellowships.
MOC in theory for continuing education is perfectly reasonable, but the price gouging and the time suck is outrageous. Adding on new rules for incoming diplomates was easy as they had no say and no clue what was happening, but they couldn’t do that to all the established diplomates for fear of restriction of trade lawsuits. However, they ingeniously split the potential lawsuit pool by more than half by letting one group out of MOC and won by complacency. Can’t help but notice the grandfathered group was also the wealthiest group as they had minimal school debt and have been in practice the longest while accruing some of the highest income to cost of living ratios for physicians ever recorded.
/end rant
thanks for your thoughts. over the years, i have seen younger and younger physicians added to the committees, but obviously still more represented by senior physicians. i would submit that the end result is the same. in other words, when faced with the rationale for proceeding with exceptions, grandfathering of some form remains the default solution. it may not be age related specifically, but some combination of wanting to permit a practitioners some independence and either conflict avoidance, unwillingness to go back a level to change some hospital bylaw, or legal issues etc, the outcome remains the same in my observations.
I mean I’m not a fan of MOC either and agree it doesn’t mean the same thing as wanting to keep learning but if the dinosaurs don’t want to play the game, then either get rid of the game or retire. Not sure why they should get prefential treatment when if anyone is dangerous it’s probably them.
what you think you look like
(borrowed from biography.com)
what the freshly graduated doctor you hired thinks you look like
(from aarp)
roughly when does this happen? after fifteen years of clinical experience? twenty? more?
literally no one will call you by your first name?
actually i do have a question for the board.
i think most young physicians are outraged when they first learn that there is something called grandfathering with respect to board certification. that if you happen to be above a certain age, that your certificate is unlimited and you don’t have to retest periodically. they bemoan the fact that the older generation sold them out. i certainly felt that way many moons ago.
so now having been in practice for a long time and have had a chance to see how decisions get made in 3 reasonably sized organizations. i can’t tell you how many times a new policy or rule is developed and someone asks well what about dr. x who has been doing this for 30 years. so a grandfather clause is made with the expectation that time will solve the problem and avoid prematurely ending someone’s career or practice pattern or whatever.
question for discussion is- how do we feel about grandfathering? is it something with nuance or just plain wrong and policies should be developed with blind eye toward how it affects specific individuals. for the sake of our discussion, which hopefully will remain civil, let’s just talk about medical policies, rather government or other stuff. eventually, if lucky, we will all be on the other side of the slope, and no longer specifically trained in procedure x or surgery y. is everything going to be like ACLS? take some computer class to authenticate your diabetes management?
thanks for any thoughtful comments.
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