Opinion : Never mind age, there’s plenty of life in veteran doctors

Dr PN Govender was honoured by the South African Medical Association with a human rights award in recognition of the significant contribution he made to his profession and community. Supplied

Dr PN Govender was honoured by the South African Medical Association with a human rights award in recognition of the significant contribution he made to his profession and community. Supplied

Published Feb 21, 2020

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Durban - VETERAN Durban paediatrician Dr TS Pillay, 80, is treating some grandchildren of patients he saw when he first began his private

practice.

Nonagenarian family physician Dr PN Govender, 90, works a full day at his practice in Merebank and drives himself to his Silverglen home at 6pm each evening.

Dermatologist Dr PN Naidu, who is nearing 80, balances his work between attending to his loyal patients and lecturing to medical school students.

These three doctors are among the scores of their colleagues who are well past the average retirement age for physicians and are still working hard.

They have not set a date for when they will stop practising. Perhaps they don’t like to contemplate life as a retiree.

In their 70s, gynaecologist and obstetrician Balaguru Naidoo’s life revolves around his profession; and surgeons Suresh Raidoo and Ponnusamy Rajaruthnam mentor junior doctors in cutting and stitching, leaving little time for their respective pastimes, fishing and golf.

The usual position of older workers is that they begin counting the days until their retirement, but that’s not the case for many doctors who have a more complicated relationship with giving up the daily grind than do many other professionals. 

When is a physician too old to practise competently and safely? At age 65? Age 75? Should it be whenever the physician decides to retire? Or should there be a mandatory retirement age for all physicians?

But first let’s look at why doctors, on average, work longer than other people?

One plausible theory is that they started their careers later. After the years spent at medical school followed by internship in a hospital and then specialisation, many physicians only begin seeing a decent salary when they are 30 or older, well after their peers who pursued other vocations.

Thus, doctors have fewer years in which to accumulate enough savings for retirement while simultaneously raising a family.

Plastic surgeon Dr Arvin Moon Lalbahadur, whose affable and humorous demeanour belies his age somewhere in the early 70s, admits he can afford to retire now.

However, he prefers providing medical care rather than performing ancillary tasks around the house.

“And there is only so much golf that you can play,” he quipped, adding that many doctors find it hard to say goodbye to a career they love and which defines their identity.

Silver-haired Dr Pillay said he enjoyed his work, liked his little patients and they too were fond of him.

Being a physician was at the core of who he was and he worried how he would feel without having to care for babies and children.

Fortunately for him, he will not be bored when he eventually decides to call it quits one day. He enjoys music - South Indian Carnatic and western classical - and also reads widely.

For 40 years, after racism in the audience was scrapped, he and his wife Vino have faithfully attended the symphony concert at Durban City Hall every Thursday.

Dr Govender, who is treating the great-grandchildren of his original patients in the Merebank and Wentworth townships, graduated six decades ago.

He worked in the discipline of

obstetrics and gynaecology at King Edward VIII Hospital, and in 1967 was dismissed for leading a protest against racially-disparate salary scales.

He subsequently became a family practitioner.

He is committed to serving the poorest of the poor until he takes his last breath.

It is clearly a genetic trait he inherited from his father, Sabapathy Periyasamy

Govender.

He was one of the famous Padavatan Six fishermen heroes who rescued 176 men, women and children from the raging waters of the Umgeni River in Springfield on October 28, 1917.

Dr Govender has a ready answer for those who ask when he will retire.

“What else can I do? I’ve done this all my life. Why should I stop doing something that I love so much? I enjoy people and I enjoy helping them. I’m not missing out on anything; I’ve had a full life.”

Does age affect competence in the medical field? There is a hung jury on this matter. Some studies claim that with age comes decreasing knowledge.

As physicians age, they tend to make more decisions based on experience instead of analytic cognitive thinking, that is, the capacity to process information to analyse and solve problems.

Then there is the school of thought that says with age comes wisdom. Some attributes needed to deliver quality health care - such as wisdom, resilience, compassion and tolerance of stress - increase with age. It is also not true that older surgeons make more mistakes than their younger counterparts.

A national law firm that specialises in professional indemnity litigation, especially in matters pertaining to clinical negligence claims, has not found that older doctors botch up more often. This means physicians of all ages are injuring patients.

Some not-so-young doctors who are confident of their ability to practise well past the stereotypical 65 years, told me recently they would be willing to undergo mandatory evaluation.

Then there are those who are in denial about cognitive decline.

Commercial pilots are required to retire before 65 and, starting at 40, they must submit to more frequent medical examinations than younger pilots.

The medical profession should introduce testing of older physicians for wellness and competence before regulatory bodies start doing so.

Many patients may be wondering whether their doctor is still competent and up-to-date on the best practices - or whether it’s time to end a trusted relationship and go find someone new.

Just as a doctor makes a diagnosis when a patient is unwell, you too can look out for certain signs that could signal it’s time for a physician to stop practising medicine.

Some red flags to watch out for are when the physician confuses a patient with another or forgets who the patient is entirely; the physician is unusually impatient; the physician gives confusing answers to the patient’s questions; and the physician forgets to complete a task, such as ordering a test, or calling a patient.

But whether or not a doctor is showing some of these signs, a patient should ultimately follow their gut. If you don’t feel comfortable or confident in your doctor, irrespective of age, find a new one.

And doctors must not make the mistake of athletes who are notorious for staying in the game too long. These athletes think they still have it, even though their skills have noticeably declined.

Devan is a media consultant and social commentator. Share your comments with him on: [email protected]

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