SALT LAKE CITY — Legislators on Monday advanced a bill that would prohibit testing a physician's competency via a cognitive test when they reach a certain age.
SB217 states that "a health care facility may not require … that a physician … take a cognitive test when the physician reaches a specified age," unless such a test conforms with standards set by the American Medical Association "for testing whether an older physician remains able to provide safe and effective care for patients."
Sen. Lyle Hillyard, R-Logan, told the Senate Business and Labor Committee he is hopeful his bill will be able to protect physicians from age discrimination.
Hillyard told the committee that it is "arbitrary to say at (a certain) age … you have to take this test" and that health care organizations "have excellent ways to protect themselves" against malpractice litigation that doesn't involve that kind of testing.
"I'm told some very prominent doctors have taken this test and failed," Hillyard said.
However, Alan Dayton, vice president of government relations for Intermountain Healthcare, said the hospital system's cognitive testing of physicians when they turn 71 years old is a common sense protocol that allows it "to keep our patients as safe as possible." He compared it to similar testing required of pilots in the commercial airline industry.
"The health care system that's conducting these tests is Intermountain Healthcare and we've implemented these tests for the purposes of safety," Dayton said. "The number of physicians over 70 has increased by 347 percent since 1975."
Dayton said of 100 doctors who have received the test, just 11 have failed.
"There's varying degrees of flunking out of this test," he said. "(Failing) doesn't mean we eliminate their ability to practice medicine, but it does mean we may limit what they do inside our hospitals. There's still a lot of services one of these physicians could perform, but others we wouldn't want them to because of patient safety."
But Utah Medical Association CEO Michelle McOmber supported Hillyard's bill, saying she worries that requiring doctors to take a cognitive test at a specific age amounts to "just aging them out of the ability to practice."
McOmber is also worried that the test itself doesn't "have anything to do with their actual practice," but rather logical exercises, she said. She added that she is aware of "many times" that young physicians would take the test in question just to see how they would do "and they would fail this test, too."
McOmber added that health care facilities already have the capacity to provide mandatory testing to their employees using "all sorts of things based on competency itself," which she said is preferable.
Rep. Ray Ward, R-Bountiful, also testified in favor of SB217 in his capacity as a family doctor.
"We want to make sure that physicians are competent to provide the services they are providing, but it's also very important not to set up something that simply becomes a way for a … health panel to eliminate providers that they don't want," Ward said. "It's very easy for this kind of thing to become a surrogate to discriminate against someone based on age."
Ward echoed McOmber's concerns about determining a doctor's "ability to do logic puzzles as a surrogate" for their medical competency and agreed with her assessment that there are other ways for health care organizations to determine their providers are adequately able.
"They do find ways to keep physicians who are not safe away from patients when that needs to happen," Ward said.
Committee members, however, were troubled by the bill's requirement that any competency test which uses a specific age meet test standards adopted by the American Medical Association, since that organization has not yet established such a test.
"I would be able to support this bill if that test existed," said Sen. Curt Bramble, R-Provo. "I've got a problem with that."
Dayton said it's the absence of a nationally accepted test that caused Intermountain Healthcare to adopt its own competency screening in the first place.
"We're waiting for that national standard, but to put it in the bill and tell us to follow something that doesn't exist — what do we do with the patients right now?" he said.
Hillyard said while no specific competency test has been created by the American Medical Association, it has already created guidelines for what such a test should look like and that "they're well on their way" to designing one.
Bramble said he could only recommend SB217 out of committee if it were amended to stipulate it could only go into effect once a test recommended by the American Medical Association has been finalized as an actionable alternative to the screening currently happening at Intermountain Healthcare. Hillyard agreed to prepare such an amendment for debate on the Senate floor.
"We can talk about it with the whole body (regarding) your concern," Hillyard said.
Following that commitment, the committee voted unanimously to advance the bill to the Senate with a favorable recommendation.