Dementia-Impaired Physicians

Today I received confirmation that my chapter dealing with HIV-infected health care workers, in Thompson-Reuters' Health Law Guide (a near- encyclopedic publication for attorneys), has been forwarded to the publisher. In that chapter, I describe the low risk of blood borne  HIV infection transmission from health professional to patient, or from patient to health professional, but the unquantified risk of judgment deficiencies in AIDS-dementia affected health care professionals in practice. The term "unquantified" indicates that I have not been able to determine the number of professionals who have the condition, the measurable effect of that deficiency on that population's judgment, or its consequences for patients.

Today's New York Times features a thoughtful article about aging physicians with dementia, a troubling subject which deserves attention (not just for physicians, but for those in other professions, as well).  These demented physicians may go unnoticed and unreported by their colleagues and noticed, but not necessarily dealt-with by family members and others who are emotionally and economically related to them.

My only significant point of disagreement with the Times article is that periodic neuropsychological testing should be more frequently used by credentialing bodies to evaluate physicians' and other health (and non-health) professionals ability to practice safely.  Use of testing would protect not only patients, but the professionals whose judgments and learning capacities are impaired, and thus prevent calamities and tragedies for both groups.

As one who has had the experience of a quiet conversation with a professional, telling him(or her)  that the time has come to retire to protect patients and himself from deterioration in his judgment and skills, and then been thanked by the practitioner and (separately) his family for doing so, I know that it can be done.