The PACE Aging Physician Assessment (PAPA)

What PAPA is:

Components of PAPA:

  • Review of self-report health questionnaires
  • History and physical examination
  • MicroCogTM Cognitive screening examination
  • Mental health screen
  • Dexterity test (for proceduralists only)

Evidence suggests that there is an inverse relationship between the number of years that a physician has been in practice and the quality of care that the physician provides. PAPA is a physical and mental health screening intended for late career physicians who have reached a certain age (generally 70 and older), but otherwise have no known impairment or competency problems. PAPA is designed to detect the presence of any physical or mental health problems affecting a physician’s ability to practice. If concerns are identified, further evaluation will be recommended. PAPA is not a diagnostic evaluation nor is it a fitness for duty evaluation. It is not intended to be used in “for cause” assessments of physicians who are suspected of having impairment. Hospitals or medical groups that have concerns about an individual physician’s fitness to practice should consult with our Fitness for Duty Program’s Administrative Director, Patricia Reid, M.P.H.,

Possible results of PAPA:

Following the assessment, a final report will be sent to the referring group that outlines whether the physician falls into one of the following two categories and what recommendations exist:

Who should use PAPA:

Any hospital or medical group that would like to ensure the ongoing health and fitness to practice of its late career practitioners would benefit from PAPA. Any hospital or medical group that has enacted a policy to screen late career practitioners would benefit from PAPA.

Why use PACE?:

The PACE Program was originally founded in 1996 to provide clinical competency evaluations of and remedial education to physicians identified as having performance concerns. The physical and mental health screening components of our competency evaluation have helped detect undiagnosed health problems in dozens of physicians that were potentially impaired in their ability to practice safely. This in turn led to the creation of the PACE Fitness for Duty Evaluation (FFDE) in July 2011, which evaluates physicians suspected of impairment due to physical, cognitive or mental health problems. The PACE Program has been at the forefront of the national conversation about how to perform an age-based screening assessment for physicians.

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