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    Older Physicians Opting Out of Patient Care

    By Joseph Caldwell, president of Staff Care*     

    One of the biggest stories of 2007 centered on the first baby boomer becoming eligible for Medicare, but it overshadowed the fact that some 75 million boomers will do the same within the next several years.

    Now healthcare news coverage focuses on strains the U.S. healthcare system will be encountering as it faces the growing medical needs of our aging population. The fact that the physician population is aging right alongside the general population will only compound the challenges faced by the healthcare system. According to the AMA Physician Master File, 47 percent of physicians in the United States are 50 or older.

    The practice plans these experienced doctors have are of great importance simply because there are so many of them. In the case that a significant number of older physicians choose to retire or opt out of patient care roles, the supply of physicians, already constrained today, will be further diminished.

    In order to track the career plans of experienced physicians, Merritt Hawkins & Associates,* a national search firm specializing in permanent physician placement, conducted a survey of physicians 50-65 years old. Results of the firm’s 2007 survey, which included responses from 1,175 physicians in the 50-65 age group, are not encouraging for those concerned by the growing shortage of physicians in the United States.     

    Calling it quits 

    Fourteen percent of physicians surveyed said they plan to retire in the next one to three years. This includes 13 percent of respondents in the 50-55 age group and 14 percent of respondents in the 56-60 age group. Many doctors in their 50s have full practices and often are considered the “work horses” of the medical staff. It’s safe to say that a significant number of hospitals and medical groups would find it difficult to cope if 13-14 percent of medical staff members in their 50s turned in their stethoscopes in the next few years.  

    Twenty-seven percent of physicians in the 61-65 age group said they plan to retire in the next one to three years. The fact that a significant number of doctors in their sixties plan on retiring in the next few years may not be surprising, but whether or not hospitals and medical groups are prepared for their imminent retirement is another matter. Eighty percent of physicians surveyed said they are not involved in a succession plan with their affiliated hospital or group, and 80 percent said they have made no plans to transfer their patients to other physicians upon retirement.

    Of the physicians surveyed, almost a quarter (24 percent) indicated they would either retire or opt out of patient care roles in the next one to three years. Seven percent said they would seek a medical job in a non-clinical setting, such as medical administration, a managerial or research role with a pharmaceutical company or other jobs not involving patient care. Three percent said they would pursue a job or business in a non-medical field.

    Slowing down 

    The survey also revealed that many older doctors, while staying in patient care roles, plan to reduce the number of patients they see over the next one to three years. Twelve percent of physicians surveyed said they will start working part time, and 8 percent said they will either close their practices to new patients or significantly reduce their patient loads. Eighteen percent of those surveyed said they have already closed their practices to new patients.

    Although these physicians intend to remain in clinical roles, it is likely that the number of patients they see will decline in the near future, forcing other physicians to pick up the slack.

    Working locums

    Four percent of physicians surveyed indicated that they will work locum tenens assignments in the next one to three years. The percentage was slightly lower for physicians aged 50-55 (3 percent) and slightly higher for those aged 61-65 (5 percent).   

    As locum tenens physicians, these doctors are less likely to see as many patients as they did in full-time permanent practices (unless they choose to work locums year-round.)   Nevertheless, they will remain in clinical roles and continue to be a part of the overall physician workforce. Without the locums option, these physicians might choose to retire or pursue a non-clinical position. Locum tenens enables older physicians to remain in patient care roles and allows for physician accessibility at a time when such contact is increasing in demand and decreasing in availability.         

    Younger doctors not as hard working?

    The survey revealed that many older physicians are under-whelmed by the work ethic of today’s younger physicians. Sixty-eight percent of older physicians surveyed indicated that physicians coming out of training today are less dedicated and hard working than physicians who came out of training 20-30 years ago. Whether valid or not, many older physicians consider themselves more devoted to medicine than their younger counterparts.

    The survey results suggest that disillusionment among experienced physicians runs deep: 44 percent of physicians surveyed said they would not choose medicine as a career if they were starting out today. Further, more than half (57 percent) indicated that they would not recommend medicine as a career to their children or to young people. Unless conditions in medicine change, it is apparent that the U.S. healthcare system is likely to lose some of its most experienced physicians in the near future. 

    The complete results of the survey are available on the  Merritt Hawkins & Associates website .

    *Staff Care and Merritt Hawkins & Associates are divisions of AMN Healthcare, Inc. (NYSE: AHS).

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