Age and anesthetic practice: a regional perspective

To obtain information about practitioners' behaviors, perceptions, and perspectives concerning issues related to advancing age and anesthetic practice.

Questionnaire survey mailed to 1,208 active and retired American Society of Anesthesiologists (ASA) members in Northern New England. Topics included hours worked, practice policies, stress level of activities, observed in colleagues and personally perceived errors and problems associated with performance, and plans, preparation, and reasons for retirement.

Practicing respondents worked in academic, community, or federal hospitals, and in ambulatory surgical facilities.

For descriptive analysis, counts and frequency distributions were calculated for each question. Statistical methods were used to test differences across age groups and to identify sources of differences. Approximately 40% of respondents in each age group worked an average work week of 50 to 59 hours. Respondents aged 40 to 49 years worked the longest work weeks and duty periods and were more concerned about liability issues than other age groups. Respondents age 60+ tended to work shorter average and maximum work weeks, although 5% of them continued to work 70- to 79-hour weeks. There was no statistically significant difference in hours worked among men and women. Approximately 20% to 30% of respondents relieved older colleagues of late night or call duties, and asked them to restrict or to stop practice out of concern for patient safety. Night call was equally stressful for all age groups. Economic uncertainty, production pressure, and interpersonal relations were more stressful for younger respondents. In preparation for retirement, shifting away from complex cases and phased reduction in clinical activity were increasingly prevalent with each advancing age group. Important reasons for retirement included attitude changes, physical limitations, and declining health.

Despite modest age-associated trends, chronological age per se is not a strong correlate of an individual's practice pattern, behaviors, or perceptions about performance.