A model for the cognitive assessment of physicians

IntroductionWith aging in the larger population and physician workforce, there has been growing emphasis on physician cognitive impairment. We propose that the determination of cognitive status in physicians, regardless of the cause, should be based on a comparison to other physicians, rather than a...

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Main Authors: Victor A. Del Bene, George Howard, David S. Geldmacher, Elizabeth Turnipseed, Catherine Brown, Kathleen Lowry, Trevor Starling, Kate Bryan, T. Charles Fry, Keith A. Jones, Ronald M. Lazar
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1555950/full
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author Victor A. Del Bene
Victor A. Del Bene
George Howard
David S. Geldmacher
Elizabeth Turnipseed
Catherine Brown
Catherine Brown
Kathleen Lowry
Trevor Starling
Kate Bryan
T. Charles Fry
Keith A. Jones
Keith A. Jones
Keith A. Jones
Ronald M. Lazar
Ronald M. Lazar
author_facet Victor A. Del Bene
Victor A. Del Bene
George Howard
David S. Geldmacher
Elizabeth Turnipseed
Catherine Brown
Catherine Brown
Kathleen Lowry
Trevor Starling
Kate Bryan
T. Charles Fry
Keith A. Jones
Keith A. Jones
Keith A. Jones
Ronald M. Lazar
Ronald M. Lazar
author_sort Victor A. Del Bene
collection DOAJ
description IntroductionWith aging in the larger population and physician workforce, there has been growing emphasis on physician cognitive impairment. We propose that the determination of cognitive status in physicians, regardless of the cause, should be based on a comparison to other physicians, rather than against the non-physician populations. Our objective was to develop a normative database of healthy physicians that can be used in physician competency evaluations.MethodsThis study was a prospective cross-sectional observation design. Cognitive test data from 190 healthy physicians between the ages of 35 and 65 without work-related concerns was collected in an academic medical center neuropsychology clinic. Our primary outcome was performance on a neuropsychological test battery. All performances were z-score transformed (Mean = 0, SD = 1).ResultsWhen comparing the distribution of our physician sample to the average performance of non-physician 45-year-olds, the average physician performance is skewed to the right, indicating group-level physician performances of 0.5 to 1.0 standard deviations higher than the general population. For overall cognitive performance, multivariate regression revealed older age (−0.18, 95%CI −0.24 −0.13, p < 0.0001) was associated with lower overall cognitive performance, but still better than the average 45-year-old, non-physician group.DiscussionIn conclusion, physicians outperformed the general public on tests of cognitive functioning. Even older physicians (ages 60–65) performed above the average general population 45-year-old, reflecting preserved cognitive abilities. Existing age-corrected methods from the general population can potentially mask cognitive impairment in medical professionals.
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spelling doaj-art-d2bd4e8c94fc4b3c98db87b9e0c4451d2025-08-20T02:39:09ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15559501555950A model for the cognitive assessment of physiciansVictor A. Del Bene0Victor A. Del Bene1George Howard2David S. Geldmacher3Elizabeth Turnipseed4Catherine Brown5Catherine Brown6Kathleen Lowry7Trevor Starling8Kate Bryan9T. Charles Fry10Keith A. Jones11Keith A. Jones12Keith A. Jones13Ronald M. Lazar14Ronald M. Lazar15Department of Neurology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesThe Evelyn F. McKnight Brain Institute, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Neurology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Neurology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesThe University of Alabama Health Services Foundation, P.C, Birmingham, AL, United StatesDepartment of Neurology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Neurology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Neurology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesThe University of Alabama Health Services Foundation, P.C, Birmingham, AL, United StatesDepartment of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesThe University of Alabama Health Services Foundation, P.C, Birmingham, AL, United StatesDepartment of Anesthesiology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Neurology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesThe Evelyn F. McKnight Brain Institute, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United StatesIntroductionWith aging in the larger population and physician workforce, there has been growing emphasis on physician cognitive impairment. We propose that the determination of cognitive status in physicians, regardless of the cause, should be based on a comparison to other physicians, rather than against the non-physician populations. Our objective was to develop a normative database of healthy physicians that can be used in physician competency evaluations.MethodsThis study was a prospective cross-sectional observation design. Cognitive test data from 190 healthy physicians between the ages of 35 and 65 without work-related concerns was collected in an academic medical center neuropsychology clinic. Our primary outcome was performance on a neuropsychological test battery. All performances were z-score transformed (Mean = 0, SD = 1).ResultsWhen comparing the distribution of our physician sample to the average performance of non-physician 45-year-olds, the average physician performance is skewed to the right, indicating group-level physician performances of 0.5 to 1.0 standard deviations higher than the general population. For overall cognitive performance, multivariate regression revealed older age (−0.18, 95%CI −0.24 −0.13, p < 0.0001) was associated with lower overall cognitive performance, but still better than the average 45-year-old, non-physician group.DiscussionIn conclusion, physicians outperformed the general public on tests of cognitive functioning. Even older physicians (ages 60–65) performed above the average general population 45-year-old, reflecting preserved cognitive abilities. Existing age-corrected methods from the general population can potentially mask cognitive impairment in medical professionals.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1555950/fullimpaired physiciansaging physicianscognitionneuropsychologycompetence
spellingShingle Victor A. Del Bene
Victor A. Del Bene
George Howard
David S. Geldmacher
Elizabeth Turnipseed
Catherine Brown
Catherine Brown
Kathleen Lowry
Trevor Starling
Kate Bryan
T. Charles Fry
Keith A. Jones
Keith A. Jones
Keith A. Jones
Ronald M. Lazar
Ronald M. Lazar
A model for the cognitive assessment of physicians
Frontiers in Public Health
impaired physicians
aging physicians
cognition
neuropsychology
competence
title A model for the cognitive assessment of physicians
title_full A model for the cognitive assessment of physicians
title_fullStr A model for the cognitive assessment of physicians
title_full_unstemmed A model for the cognitive assessment of physicians
title_short A model for the cognitive assessment of physicians
title_sort model for the cognitive assessment of physicians
topic impaired physicians
aging physicians
cognition
neuropsychology
competence
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1555950/full
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