Most doctors avoid facing facts of life, one of which Madhok discusses boldly on page 215 in his article "Should Doctors Retire"?

Madhok has neither discussed, nor mentioned the age of retirement. Here we are discussing only private practitioners, to whom no financial help is available once they retire. Should the retirement age be 58 as in government service, or 65 as in many private organisations? The topmost industrialists of the world are above 75 years of age and yet, as directors of companies, they make accurate decisions. Birlas, Tatas are such examples, as are heads of many other business houses. Coming to professionals like solicitors and physicians (I shall not comment on surgeons) - most of them are in demand at that age. The people go to them because of their vast experience and wisdom and for sure, most of them get better opinions. Similarly, the moment there is a "difference of opinion" in the diagnosis, the patient would like to consult a senior physician. Although I do not agree with this approach, it will take a couple of years for the people to realise that a young super-specialist who has seen many more patients with that particular problem, is, any day better equipped to handle the case. But what happens when two leading cardiologists differ in their opinion, and choice between Coronary Angioplasty and Bypass Surgery? In such cases, the patient would then depend on the opinion of the senior-most doctor.

What is old age to a professional? In my opinion if a person goes on working, the chances of slowing of the memory, etc. are less likely to occur. To put it differently, if a doctor has a good clientele and remains busy, his diagnostic acumen is not likely to deteriorate. But if a doctor loses his clientele after the age of sixty or so, he would no longer have the incentive to read any medical literature and remaining idle in the clinic would only hasten the deterioration of his clinical acumen.

There is another aspect in the medical field (physician's arena). Nowadays, there is the functional element of symptoms super-added to every organic disease. Even pure functional illnesses are increasing. Thus in a country like India, where faith plays a very important role in the relief of symptoms, the patient feels much better when they consult an elderly physician, who can clear their doubts and remove any suspicions from their mind.

Even the people can identify a young physician in his sixties who is so slow that he is worse than a doctor in seventies. And yet a doctor in his seventies, who is very busy talking, examining and discussing can pass off, in the minds of the people as the one in sixties. Sure enough when a patient takes an appointment, he does not ask for the age of the doctor.

As Madhok says, the question is that if you retire, how do you look after your family's financial needs? So there may be a point in the doctor continuing to work till he is fit to do so and has a good memory (which sure enough smart patients can spot).

I have a few more suggestions to offer:

1. As in Government hospitals, so in all private hospitals, the specialists should be asked to retire at around 65-75 years of age, so that the young doctors get a chance to work. If the doctors have already made enough 'name and fame', their private practice can keep them going.
2. In fact, except for those who are in private practice, all the doctors at the above age should retire.
3. Yes, in such a case the income of the doctor might fall. Fortunately by this time, the doctor's children should have finished their education and settled, and sure enough the doctor now needs much less income than his younger days.
4. The only solution to keep some good income coming, is, to raise the consulting fees as the doctors become senior. In Mumbai, I see young doctors charging Rs. 500/- to 1500/- as consulting fees (double for the home visits), while many senior doctors are still charging less fees. This is wrong. Like paying solicitors, the patient should be ready to pay high fees to senior doctors who would then be seeing less number of patients and yet get enough to survive!
5. As Madhok mentions, as the doctor will spend less time in the clinic, there is more time at his disposal to start new hobbies, when his friend's circle and social contacts have decreased.
6. It is time the doctors also realise that every doctor should also be a businessman and learn to invest money right from his youth. In addition, he should have mediclaim and life insurance. Then, any additional income in old age would supplement the savings.

I fully agree with Madhok, that in our country, thousands of doctors whose knowledge has dwindled and whose reflexes have slowed markedly, are not doing justice to themselves and to the population by continuing to pursue.

Madhok had made the start of a very important topic, an issue which neither our Government nor our politicians are inclined to sort out. The problem has to be solved at our level only.

By the way, most of the famous politicians who are ruling our country are in their late seventies and eighties!

May be the new law (which may be passed) where every doctor has to pass an examination every five years will answer the question - which old doctor can continue to practise.