Physicians Are Aging Out of the System
Just like the general population, physicians in the U.S. are aging.
Of the approximately 860,000 physicians in the U.S. who in active patient care, 30% are 60 or older, while 23% are 65 or older, according to the Association of American Medical Colleges (AAMC). Over one in five physicians now is at retirement age, and many more will be in a few short years. We are facing what AMN Healthcare calls a “physician retirement cliff.”
In some specialties, the drop off this cliff will be particularly precipitous. Currently, 66% of pulmonologists are 65 years old or older, as are 46% of psychiatrists and 32% of orthopedic surgeons, the AAMC reports.
Physicians in surgical, internal medicine, and diagnostic specialties are, on average, older than physicians in primary care. For example, the average age of cardiac surgeons is 59, compared to 49 for family physicians.
This presents a critical public health challenge because we will need significantly more specialists to treat the ailments of a growing elderly population. The U.S. Census Bureau projects the number of people 65 and older will increase by 34% by 2036, compared to just 8% growth in the general population. People 65 and older see physicians at three times the rate of younger people, according to the Centers for Disease Control and Prevention (CDC). While seniors represent only about 14% of the population, they account for 37% of diagnostic tests and 35% of inpatient procedures, the CDC reports.
Alarmingly, specialists who treat aging hearts, lungs, musculoskeletal systems, nervous systems, and other organs will be aging out just when we need them most.
How Do We Address the “Physician Retirement Cliff?”
One way to address this challenge is to train more physicians, but that takes years and requires funding that Congress appears reluctant to allocate. Focus therefore should be placed on keeping aging physicians in the workforce as long as possible.
This means creating a more favorable medical practice environment and eliminating or ameliorating the things that cause physicians to abandon patient care roles or leave medicine entirely. The practice of medicine has transformed since many older physicians first entered the profession.
Physicians have gone from being mostly owners of independent medical practices to employees. The amount of non-clinical paperwork duties they must perform has expanded exponentially. Many feel they have lost clinical autonomy and the heart of the physician/patient relationship that attracted them to medicine in the first place.
We can’t change that reality entirely, but hospitals, medical groups and other employers can make efforts to reduce physician data entry duties, increase physician clinical autonomy, increase patient face time, invite physician input, and create a more efficient, physician-friendly work environment.
Flexible work models also can help promote physician retention. These models include part-time work, telemedicine, and temporary assignments, known as locum tenens. The option to work locum tenens has allowed thousands of physicians who may otherwise have retired to remain in patient care. AMN Healthcare estimates that over 52,000 physicians work as locum tenens each year, many of them older physicians.
The physician retirement cliff is approaching, and the new physicians we need to address it cannot be trained overnight. It only makes sense to keep the physicians we have engaged and productive.
