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Faculty Senate votes on screening policies for late career physicians

At Thursday’s Faculty Senate meeting, members voted to pass a motion recommending that University leadership advise the Stanford Hospital and Clinics, Stanford Health Care and Stanford Medicine to end screening processes that apply to Medical Center practitioners 74.5 years or older in age.

The Faculty Senate also discussed diversity in university doctoral programs as well as changes in the body’s leadership.

In 27-to-9 vote (with two abstentions) by secret ballot, a motion passed to support uniform competency testing of all medical practitioners as a safeguard for patients.

Professor Robert Simoni of the Biology department introduced the motion in opposition to the Stanford Hospitals Medical Staffs Late Career Practitioner Policy

The policy, which passed by a Medical Staff vote of approximately 53 percent in December 2013, requires all practitioners aged 74.5 years or older to complete health screening and peer assessment of their clinical skills every two years in order to provide direct patient care.

According to the policy, younger practitioners are also required to complete these processes if concerns are raised about their ability to practice competently.

“That is age discrimination in its simplest form,” Simoni said.

Professor of Medicine Emeritus Frank Stockdale, spoke in support of Simoni’s motion.

“It has not been documented that late-career faculty at the Stanford Hospital disproportionately harm patients,” said Stockdale.

Stockdale added that physicians involved in the hospital’s malpractice lawsuits are more likely to be 45 to 55 than 75 or older. He also pointed out that 20 of the hospital’s approximately 1,800 physicians are late career physicians.

Professor of Medicine Ann Weinacker spoke in opposition to Simoni’s motion.

“This policy was designed to put the well-being of patients above our own issues. It was also intended, however, to be supportive of physicians who may be dealing with age-related declines in physical and cognitive functions,” said Weinacker.

According to Weinacker, physicians 74.5 years and older are at risk of higher impairment based on advancing age.

“In medicine, screening for any illness or impairment is based on the probability of having the condition in question, so this isn’t discrimination,” Weinacker said.

“Well-structured, rigorous peer review is useful to evaluate the cognitive, physical and humanistic aspects of performance of physicians when done in a confidential and compassionate manner,” Weinacker added.

The California Medical Association, the California Hospital Association’s Center for Healthcare Medical Executives and California Public Protection and Physician Health have published guidelines for assessing late career practitioners specifically.

The University of Virginia and the University of Pittsburgh Medical Center have implemented late career practitioner assessment, and other hospitals nationwide are developing similar policies, according to Weinacker.

Weinacker emphasized that the Stanford Hospital Medical Staffs is a quasi-independent organization comprising community and faculty positions.

Weinacker also explained that the University has an anti-age discrimination policy and faculty over 74.5 years can teach and conduct clinical research without fulfilling screening requirements for obtaining clinical privileges.

Professor Stockdale contended that faculty members cannot carry out their professorial duties without having the privilege to conduct patient care.

Screening requirements for late career physicians, he added, have created a hostile work environment at the hospital and have led to retirements and protests among faculty who feel unwelcome.

Professor Simoni urged the Faculty Senate to use its moral authority to support his motion in opposition to the medical staff’s late career physician policy.

“This is a matter of academic freedom at its most fundamental,” Simoni said.

Also at the meeting, Vice Provost for Graduate Education Patricia Gumport appeared before the Senate to report findings on the status of diversity in the University’s doctoral programs.

Compared to the undergraduate program at Stanford and other doctoral programs at peer institutions, nearly all doctoral programs at Stanford have lower representations of women and minorities.

The economics, math and statistics doctoral programs have no underrepresented minorities. However, compared to its peer institutions, Stanford has slightly higher percentages of underrepresented minorities in doctoral programs for biology, life sciences and social sciences (not including economics).

The University also outperforms its peers in terms of female representation in the earth sciences and engineering (other than computer science) Ph.D. programs.

“The data are very sobering, especially with regard to underrepresented minorities,” Gumport said.

In recent years, Stanford has increased representation of women and minorities in STEM fields through fellowship programs such as the Enhancing Diversity in Graduate Education (EDGE) Fellowship and the Diversifying Academia, Recruiting Excellence (DARE) Doctoral Fellowship Program.

Gumport believes that Stanford is a national leader with respect to the initiatives it has implemented to diversify the academic pipeline.

Changes in Faculty Senate leadership were also announced Thursday.

Academic Secretary to the University Hans Weiler announced that Applied Physics Professor Kathryn Moler has been elected Chair of the Faculty Senate for the 2015-16 academic year. History Professor James Campbell has been elected Vice Chair.

 

Please contact An-Li Herring at anlih ‘at’ stanford.edu

 

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