A Pilot Study of a Screening Process for Evaluating the Physical, Mental and Cognitive Health of Senior Physicians

Abstract

Physicians are not immune to changes that accompany aging, including decreases in physical and cognitive health and abilities. Many are calling for, or turning to, screening senior physicians for decrements in their ability to provide safe care. Our purpose was to determine the acceptability and feasibility of a pilot screening process, which evaluates the physical, mental and cognitive health of senior physicians. The screening process was developed by the University of California, San Diego, Physician Assessment and Clinical Education Program. The screen included: mental health screening (PHQ-9, GAD-7, and substance abuse screen), cognitive health screening (MicroCog™ and Montreal Cognitive Assessment [MoCA©]) and physical health screening (medical history review and physical examination). Qualitative semi-structured interviews were conducted post-screening. Thirty senior physicians participated in the pilot process, including post-screening interviews. Eight (27%) participants were judged to “require”/“may require” further evaluation after cognitive assessment. No physicians were found to have physical or mental health issues that would prevent them from practicing competently. Interviews revealed that participants felt the screening process was a positive experience that was effective, acceptable, efficient and relevant to their practice. The results of this pilot study indicate that screening physical, mental and cognitive health is considered both feasible and acceptable to senior physicians. This is important as screening the health and cognition of senior physicians is integral to the national discussion related to regulation and patient safety.