Identifying neuropsychologically impaired physicians.

Area of Science:

• Neuroscience
• Medical Professional Health

Background:

• Growing concern for cognitive impairment in the aging physician workforce.
• Increasing focus on reducing medical errors in healthcare.

Purpose of the Study:

• To establish and validate an approach for detecting neuropsychological impairment among physicians.
• To identify objective criteria for classifying cognitive status in medical professionals.

Main Methods:

• Compared neuropsychological test performance of 30 clinically-referred physicians with 39 healthy community urologists.
• Defined impairment based on scoring ≤5th percentile on ≥5 of 9 key cognitive and motor variables.
• Classified referred physicians as 'impaired' or 'ambiguous' based on test results.

Main Results:

• A cutoff of ≥5 impaired test scores best balanced classification models.
• 14 of 30 clinically-referred physicians (46%) were classified as impaired.
• Impaired physicians were older, more likely suspected of neurodegenerative disorders, and more likely to have stopped practicing.

Conclusions:

• A substantial subgroup of clinically-referred physicians can be identified as neurocognitively impaired using conservative criteria.
• Initial validation of the proposed methodology was achieved.
• Replication with larger samples and development of specialty-specific criteria are recommended.