PLANNING for transition to retirement should begin for doctors as early as their mid-50s, say researchers, who have found that many older clinicians are uncertain about their plans, or have no intention to retire.

In a cross-sectional survey of practising doctors aged 55 years or older, published in the MJA, researchers found that 26.6% of the survey’s 1048 respondents were unsure of their retirement plans, and 11.4% had no intention to retire.

Clinicians with adequate financial resources and greater anxiety about ageing were more likely to have firm retirement plans; while international medical graduates, clinicians with greater “work centrality” and greater emotional resources, were less likely to have retirement plans in place.

Lead author Associate Professor Chanaka Wijeratne, senior psychiatrist with the Academic Department for Old Age Psychiatry at the Prince of Wales Hospital and Associate Professor (Adjunct) at the University of Notre Dame’s School of Medicine, said that attention to the importance of retirement planning was overdue.

“We talk about transitioning from medical student to junior doctor, from junior doctor to consultant, but we haven’t really spoken about transitioning into retirement,” Professor Wijeratne told MJA InSight. “The traditional notion is that you work until you drop.”

He said it was not surprising to find that work centrality was a key factor in clinicians’ hesitance to make retirement plans.

“Medicine is an intrinsic and very deeply felt part of someone’s identity because they have spent so long getting through medical school and then developing their career and expertise,” he said.

Professor Wijeratne said that medicine also attracted people with perfectionistic, obsessional personalities who tended to overcommit to their careers.

“Those kind of personality traits are probably exacerbated by the very culture of medicine – working long hours, working harder than your peers, to get on with your career,” he said.

Co-author Associate Professor Joanne Earl, of the Flinders Business School, said that retirement should be thought of in terms of career management.

“People always think about the day of retirement as an event, but … it’s very much a process of transition,” Professor Earl told MJA InSight.

“It doesn’t need to be all or nothing; it can be a combination of [changes]. It may be a new career direction, a reduction of hours, or scope of work.”

Professor Earl said that a focus of retirement discussions was often “how much will I need to retire?”, but the more important question for doctors to ask themselves was: “what am I going to do in retirement?”

“People tend to ‘park up’ their plans to enjoy a full life until retirement. They say they want to play golf, paint more or travel extensively but, in reality, only about 25% of people take up new activities in retirement,” she said. “I would encourage people to stop thinking about those activities and to get involved in them now.”

Speaking in an MJA InSight podcast, Professor Brian Draper, clinical lead of the academic department for old age psychiatry at Sydney’s Prince of Wales and Prince Henry hospitals, said that age-related physical and cognitive changes affected all professions and jobs – from doctors and pilots to bus drivers.

“As you get older, you have to change the way you work, so there are certain capacities and skills that erode much slower than others,” Professor Draper said. “Your general expertise and knowledge, ability to mentor, ability to give guidance and leadership – the wisdom, if you like – of the profession, is going to be retained much more than perhaps the fine-honed skills of being a surgeon who has to have a steady hand.”

Professor Draper wrote in an editorial accompanying the MJA research that the move towards revalidation, as being considered by the Medical Board of Australia, was complementary to retirement planning by ensuring that older doctors maintained up-to-date knowledge and were fit to practice.

The MJA authors also called for the development of education programs facilitating retirement planning for late-career doctors, and Professor Wijeratne pointed to a Welfare of Anaesthetists Special Interest Group position statement as a “brilliant model”.

Support for late-career doctors needed to come from the profession, employers and regulators, said Dr Genevieive Goulding, founding member and former chair of the Welfare of Anaesthetists Special Interest Group, a group supported by the Australian and New Zealand College of Anaesthetists, the New Zealand Society of Anaesthetists and the Australian Society of Anaesthetists..

She said that employers could support older doctors by providing flexible career opportunities, such as reducing an older clinician’s on-call and face-to-face clinical load in favour of more mentoring and teaching opportunities.

“We know that your physical skills drop off as you age. You start by wearing glasses, your hearing [deteriorates], you don’t tolerate being up all night – all these things are happening physiologically that you really can’t control,” she said. “Departments have to be very flexible and responsive with their workforce to be able to accommodate these individual needs.”

Dr Goulding agreed that revalidation could play a role in ensuring that older doctors maintained their skills, but there were limitations to this approach.

“Revalidation is important but it doesn’t actually indicate what a surgeon is like in an operating theatre, for example,” she said, adding that multi-source feedback, and perhaps a mandatory retirement age, should be considered.

However, Professor Wijeratne said that there was no evidence to support the implementation of a mandatory retirement age in medicine.

A podcast with Professor Brian Draper is available here.

To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.

 


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11 thoughts on “Doctors and retirement: plan early

  1. Richard Lewandowski says:

    Our career doesn’t offer a pathway for s niors to transition while still adding value.
    I have tried to engage groups about this without any traction
    It is time to make this a part of a medical career

  2. ex doctor says:

    These are all very laudable observations regarding medical retirement. Unfortunately they crash headlong into the Medical Board of Australia/AHPRA definition of professional practice. Politicians may be pleased with their work in cleaning up medical practice and protecting the public but it is riddled with unintended consequences. The ability to continue to be a “doctor” while fully retired has for all practical purposes been exterminated.

  3. Anonymous says:

    In this age when people are living longer, why is 65 considered to be old and why should doctors not continue to practice when they are capable and still enjoy the work.
    Next old(er) doctors will be subject to consideration for euthanasia.

  4. Robert Henderson says:

    I would refer Richard Lewandowski, and all others interested in this most important issue, to the ASADA (Australian Senior Active Doctors Association) website (asada.net.au). This organisation was set up over 5 years ago to specifically ‘engage groups’ to gain ‘traction’ by actively lobbying for changes in this area.

  5. Anonymous says:

    I “retired” when I was 75, and wrote down plans: Complete an MD (done), join an orchestra (done) and start some volunteer work (done). But I did continue paid work one day per week, and still do this. I am careful to ensure that everyone knows that I know my limitations, and I give lots of room for colleagues to hint that I should stop. So far this hasn’t happened.

  6. Anonymous says:

    I agree with “ex-doctor” above. Under AHPRA it’s all or nothing. The organisation seems pleased that it’s managed to do this, but frankly they should be ashamed of themselves. What happens during a pandemic? Who’s going to work for Red Cross and MSF? Who’s going to use their new found time to offer their services at sporting events? The list goes on.

    It behoves doctors approaching retirement to plan around what “Big Brother’s” latest thought bubble is. Even ten years after retirement I still miss being able to help out a friend with a referral or a repeat prescription. I’ve also stopped using the honorific because I don’t consider myself a “proper” doctor anymore. When asked I say “I *used to be* an anaesthetist”.

    Yes, retirement is just that. Forget all the skills you spent decades learning, practicing and teaching, unless you’re prepared to jump through hoops held by Dr Flynn and her cronies, most of whom have no medical qualifications.

    Plan now or suffer the consequences that those of us who had AHPRA rise from the black swamp during our retirement.

  7. Stewart Parkinson says:

    I “transitioned to retirement” at age 60 – from working 40 hours per week to working 16-18 hours per week. Life has never been better. I have always wanted to target shoot – I now do that 1 to 2 days a week and have started reloading and testing ammunition, which keeps the mind active. I have also enjoy fishing but find other activities preclude taking the boat out as often as I would like. I enjoy my 16-20 hours work, not from a financial aspect but from a social perspective. I plan to continue in this “transition” for another 5 or so years and highly recommend semi-retirement.

  8. Anonymous says:

    I would love to slow down as Dr Parkinson has done but as a rural practitioner doing procedural work and living with more than 15 years of failed succession plans I have to come to grips with the loss of services in my town once my remaining pair of colleagues and myself step away from the hospital. Once we are gone the chance of re-igniting the much needed and somewhat under-appreciated care we offer the community with our GP obstetric, surgical and anaesthetic skills would seem to be a near impossibility. Our offers to mentor younger graduates in these areas will fade very soon. Who will care for us and our families in this town when we might need such support?

  9. Dr R Yeow says:

    “…Professor Draper wrote in an editorial accompanying the MJA research that the move towards revalidation, as being considered by the Medical Board of Australia, was complementary to retirement planning by ensuring that older doctors maintained up-to-date knowledge and were fit to practice….”
    Just wondering if this would be considered as a form of age discrimination and reportable to the AHRC and Dr Triggs ?

  10. Anonymous says:

    Retirement was invented by Bismarck in the 19th century(1881) when he unifed Germany to get rid of all the old men in the German parliament. 70 was chosen as the cut oC, provided they lived that long!

    Before that if you were alive you worked.
    Now in 2017 people are healthier, Life is longer. People are active members of the community= the medical community. People are being encouraged to work longer
    They should be appreciated/ they should be encouraged/ they should be helped with work- life balance when they graduate from medical school/ they should encouraging continuous learning with continuing professional development /with a healthy lifestyle and shown how to look after themselves /POSITIVE SUPPORT should be given to them= classes should be run on how to stay healthy physically /and mentally =cognitive Learning and improvement should be one of the skills that is taught regularly so that you keep your memory in _ne tune. This should be taught.
    It’s not hard to do this to help your memory, and your learning skills.
    ALL OF THIS IS A POSITIVE APPROACH TO people as they age in medicine .
    Their knowledge and skills can be used for many years after 70, for patients and teaching and other members of the medical profession ,with a positive approach to keeping them healthy and with good cognitive skills.

    What has appalled me is the industrial strength” Domestos “used to get rid senior doctors by the Medical Council of AHPRA and their use of professor Wijneratne , who is making a career of getting people gone from the medical profession.
    He is a self-proclaimed expert having never done most of the areas of medicine on which he pontifcates.

    These people are like the Council in Star Wars, the Evil Empire .
    These people need to be gone through with their own cleaning quid to be rid of them .

    A new approach needs to be established and taught to HELP these people who are contributing members of the medical profession should be looked after, and honoured because they have the desire to contribute to the community and their patients in various ways. Obviously a doctors workload will gradually diminish,but this transition can be gradually done. In a nurturing caring environment helping them to stay healthy , keep every possible cognitive skill and continue to learn .
    This is a positive approach which we should take in the future. These people are needed Australia is it at a crossroads of increasing population and increasing need for these people ‘s skills.

    Who made Dr Wijneratne an expert in negativity as regards the future of these doctors? I don’t know !
    Who instructed AHPRA the self appointed right to dismiss people due to age. I don’t know . It is not their self-proclaimed ” protection of the patients” .
    It is protection of their livelihood, position ,cronyism.
    Let us get these negative people gone.
    Now start a new approach to care, honour ,and support our senior members of the profession, so they can usefully contribute, and gradually reduce their work and pick up theirlife balance (Bridge,Sudoku !
    🤗 )as they wish to drop the work , of course with support from their colleagues.

    In the Hippocratic oath is “to hold him who has taught me this art as equal to my parents and

    to live my life in partnership with him “

  11. Anonymous says:

    I concur with the AHPRA comments above. This is a body which now seeks to sideline any medical professional with a hint of “disability”… including senility. It seems to focus on our perceived faults and disregard the positive contributions we can make. Personally, I’d rather see my wisened experienced 70 year old GP than a freshly minted one.

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