How can society tell when a doctor is too old to practice safely? As physicians age, debates about mandatory testing or retirement intensify Richard David Heekin’s long career as an orthopedic surgeon ended catastrophically. Heekin retired at 65, in 2020, after patients accused him of continuing to operate while impaired by a progressive neurological condition that affected his balance and speech.
Within three years of his retirement, at least 522 lawsuits had been filed against Heekin and Ascension St. Vincent’s Riverside Hospital in Jacksonville, Florida. Plaintiffs charged that the hospital knew of the surgeon’s declining condition but allowed him to keep operating anyway.
The damage described in the lawsuits was severe. One patient died, after Heekin allegedly fractured her femur during a hip replacement; others accused him of fracturing other bones or rupturing tendons and severing nerves. The hospital has accepted liability in some but not all of the cases.
AI won’t replace radiologists, but will dramatically change their jobs Extreme as Heekin’s case may be, it reflects a fear preoccupying healthcare administrators, patient advocates and researchers: What happens when aging doctors continue practicing as their abilities decline? Nearly 47 percent of active US physicians are now 55 or older — up from about 38 percent in 2007. There are sound reasons for concern.
On average, many aspects of cognition decline as people age. Processing speed, working memory and attention are particularly vulnerable. Diseases that can affect someone’s ability to function well are also more common with advanced age: The frequency of mild cognitive impairment rises with age, from 8.4 percent among adults between ages 65 and 69 to 25.2 percent among those age 80 to 84, according to the American Academy of Neurology.
Many serious neurological diseases, such as Parkinson’s, Alzheimer’s and the rarer disease from which Heekin reportedly suffered, progressive supranuclear palsy, are also more prevalent in older people. Yet people vary dramatically as to when these changes begin and how rapidly they progress. This variability — and what some researchers describe as “under-reporting” — may help explain the lack of conclusive evidence that age itself leads to worse performance by physicians.
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