T
MA President Michael Speer, MD, who turns 70 this year, works similar hours in the same new- born intensive care unit. He says he has no plans to slow down but may “partially retire” in three years. Dr. Speer has envisioned life after medicine and says he may delve into wine making, do some traveling, and take or teach some college classes. “I like what I do. I like caring for babies, being involved in
organizational leadership, teaching, and keeping up with the practice of medicine. Also, in 2008, when the economy went south, I, like many Americans, couldn’t retire,” he said. Drs. Guillory and Speer are part of a national workforce
trend the American Medical Association is tracking. AMA data show a larger proportion of physicians than in the past are remaining in the medical field as they approach and even sur- pass the typical retirement age of 65. For Texas, the Associa- tion of American Medical Colleges (AAMC) 2011 State Physi- cian Workforce Data Book shows 24 percent of Texas physicians are older than 60 (see page 18). Alice Gong, MD, professor of pediatrics at The University of
Texas Health Science Center at San Antonio, has a theory why physicians remain in medical practice well beyond traditional retirement years. “We are passionate about our work, and despite the negative parts of medicine, it boils down to us and the patients. We’ve been trained to alleviate suffering, and practicing medicine is a calling similar to that of a priest. For many of us, practicing medicine is an innate part of our being,” she said. Dr. Guillory, associate professor of pediatrics at Baylor Col- lege of Medicine, adds that physicians who still practice in their 60s and beyond 65 have a wealth of knowledge to impart to the next generation of physicians.
“That type of invaluable mentorship is our legacy, and we hope to pass the baton to younger physicians who’ve benefit- ted from our experiences,” Dr. Guillory said.
Retirement wave looming
As aging physicians begin planning for life in retirement, ex- perts say the health care industry needs to brace itself for a substantial departure of seasoned professionals. “The Future of Medical Practice: Creating Options for Prac- ticing Physicians to Control Their Professional Destiny, “ a white paper for the Physicians Foundation by Jeff Goldsmith, PhD, examines the coming physician retirement wave. Dr. Goldsmith, associate professor of public health sciences at the University of Virginia, describes the past five years as “a period of pro- fessional limbo for many older American physicians.” The economic recession dis- rupted retirement plans for many of the more than 230,000 physicians older than 55 practicing in the United States. If the U.S. economy rebounds and property val- ues recover, Dr. Goldsmith predicts, the U.S. health care system will witness a massive withdrawal of physicians from
Michael Speer, MD 16 TEXAS MEDICINE June 2012
active practice, as many as 100,000 in the next five years. The potential exodus would occur simultaneously with 36 million baby boomers entering the Medicare program and perhaps 30 million more Americans receiving new health care benefits through health system reform if it survives legal challenges. To access the white paper, visit the Physicians Foundation website,
www.physiciansfoundation.org. The Physicians Foun- dation formed in 2004 as part of a settlement in an antirack- eteering class action lawsuit between physicians and medical societies and Aetna, Inc. Louis J. Goodman, PhD, CAE, execu- tive vice president and chief executive officer of TMA, is presi- dent of the Physicians Foundation. The AAMC Center for Workforce Studies estimates the United States will face a shortage of 124,000 to 159,000 phy- sicians by 2025. AAMC says an acute physician shortage will profoundly impact health care access, quality, and costs. AAMC advocates boosting enrollment in U.S. medical schools by 30 percent, along with increased efficiency, better use of health care professionals, and new models of care to address pro- jected physician shortages. Older physicians haven’t retired in droves yet, but Dr. Speer worries their eventual departure will affect primary care nega- tively and says the specialty is vulnerable. Pediatrics, internal medicine, and family medicine are ailing because fewer medi- cal graduates are choosing careers in these specialties. “Primary Care Specialty Choices of United States Medical Graduates, 1997–2006,” published in the June 2010 issue of Academic Medicine, reports an overall decrease in the propor- tions of medical graduates selecting primary care specialties (see page 21). Dr. Guillory adds many students choose primary care sub- specialties because they’re more lucrative, making it possible for them to repay student loans more quickly. AAMC reports that the total average student debt has risen to $161,000. Once aging primary care physicians retire, Dr. Guillory says, the potential access-to-care implications for Texas patients are a grave concern. “The shortages brought on by retirement coincide with an
increasing demand for patient care. There is great difficulty in finding a replacement for retiring pediatricians, for example. The U.S. child population growth outpaces the demand for board-certified pediatricians. Combined with the aging pedia- trician’s inability to pass the baton to the next generation, a crisis is created,” she said.
Physicians consider retirement Dr. Gong, a member of the TMA Committee on Maternal and
Perinatal Health, started thinking about the future of her ca- reer last year while putting together a presentation, titled Ag- ing in Practice, for the Texas Pediatric Society (TPS) annual meeting.
“In the process of examining aging in medical practice, I re- alized that I’m not alone; other physicians are grappling with the same concerns, such as what they’ll do after they retire,” she said. At 57, she’s not planning to retire in the near future. Dr.
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