title: Physician health and wellbeing provide challenges to patient safety and outcome quality across the careerspan.
abstract: OBJECTIVE
  Age correlated changes in mental and physical capacity have contributed to increasing concerns about older physicians' clinical competence. This paper explores the relationship between age and health in a clinical population referred for fitness for duty evaluations.
  
  
  METHODS
  Fifty cases from an evaluation center performing fitness for duty evaluations were randomly selected. Cases were reviewed for referral reason, demographic information, diagnosis, and recommendations.
  
  
  RESULTS
  Age ranged from 28-70 (median age of 51, mode of 45).Eighty-eight percent of cases had a diagnosed medical condition with potential cognitive sequellae.
  
  
  CONCLUSIONS
  While the literature supports performance concerns in aging practitioners, health independent of age, appears to be an important contributing factor. A screening process considering biopsychosocial reserve and professional load while applicable to older clinicians would optimally be implemented for physicians across their careerspan.
authors.affiliation: Clinical Associate Professor, Department of Psychiatry, School of Medicine, University of Kansas and Clinical Program Director, Professional Renewal Center, Lawrence, KS, USA bwilliams@prckansas.org.
authors.forename: Betsy White
authors.initials: BW
authors.lastname: Williams
authors.affiliation: Director of Psychological Services, Professional Renewal Center, Lawrence, KS, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Flanders
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000523:psychology*; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010817:Physician-Patient Relations; D010820:Physicians / Q000592:standards* / Q000706:statistics & numerical data*
keywords: aging; clinical competence; fitness-for-duty evaluations; heterogeneity