Surgeons must accept the same inexorable deterioration in physical and cognitive function in all aging humans. Although the vast majority of practicing elderly surgeons are excellent—as many as 20,000 older than 70 years in the United States—a few are not, a fact known to every chief of surgery and hospital president. The public believes that we, as a profession, police ourselves but this is illusory. At the same time, it is ethically imperative that we do so. Mandatory retirement at a certain age would be inappropriate and unfair due to the vast variability in function among individuals, a variability that actually increases with age. We propose as an option The Aging Surgeon Program, a 2-day comprehensive, multidisciplinary, objective, and confidential evaluation of a surgeon's physical and cognitive function. This program balances patient safety and liability risk with the dignity of a committed surgeon and his or her value to society.
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