Fewer physicians move, a sign of career caution
■ The rate that doctors left positions declined for a third year, possibly reflecting later retirements and economic uncertainty.
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Physicians changed addresses at a lower rate during the last year than in the previous three years, according to a survey of 253,000 medical offices.
Each year, SK&A, an Irvine, Calif.-based Cegedim firm that specializes in health care marketing information, compiles a database of 664,600 physicians who work in medical offices. Since 2008, the firm has published a report on the "move rate," which indicates how many physicians are no longer at a given office because they moved, retired or died.
Based on survey answers between March 2010 and March 2011, the firm calculated an 11.3% move rate for its most recent report, marking another year of decline. The move rate was reported as 12.4% in 2010, 15% in 2009 and 18.2% in 2008, according to SK&A.
Experts say the move rate, though an unscientific measure, could reflect the ways in which the economy is keeping physicians from changing jobs or retiring, including financial stress, the medical liability environment and licensure laws.
Physicians "don't seen to be motivated by the factors that in the past have caused a desire to move -- a big caseload, a better salary [elsewhere], or a better community with better amenities," SK&A spokesman Jack Schember said.
SK&A publishes its data for the benefit of pharmaceutical and medical equipment companies who want to sell to physicians, but the figures are one lens through which to view the economy's effect on physician practices.
Mark Doescher, MD, MSPH, director of the University of Washington Center for Health Workforce Studies, said a more stable work force could be good for areas facing a declining number of physicians and other health professionals, mainly outside major cities.
"I do think the down economy has actually caused stability in the work force, which is good for many rural locations," he said. "But when people do retire, we're going to see some difficult times ahead."
J. Deane Waldman, MD, a pediatric cardiologist at the University of New Mexico Children's Hospital in Albuquerque and an author who writes about the health care system, cautioned that the SK&A move rate isn't a scientific measurement of physician turnover or retirement.
But he said it makes sense that physicians would be unlikely to change jobs or retire now, given a long list of pressures: uncertainty about health system reform, declining income due to falling reimbursement rates, a constantly shifting medical liability environment, licensing regulations that make it difficult to relocate, and a shortage of physicians that makes it difficult to find someone to take over a practice.
"You add up all the uncertainty, financial losses, change in laws, and it's not surprising people are afraid to make any change at all," Dr. Waldman said.
For those who find a place to go, selling their homes might make it difficult or impossible to leave without taking a financial loss.
A report released May 19 by the Conference Board research group reinforced the difficulty many health care workers face as they reach retirement age. The health industry experienced the largest decline in retirement rates between a 2004-07 survey period and a 2009-10 survey period, according to an analysis of delayed retirement across all industries. Only 1.55% of full-time health care workers age 55 to 64 retired within 12 months of the 2009-10 study period, compared with 3.95% in 2004-07. The health care sector had the lowest rate of retirement, significantly less than the other industries studied.
The SK&A survey found that doctors in some specialties are much more likely to retire or move than their peers. Physicians specializing in aerospace medicine had the highest move rate at 27.9%, and plastic surgeons had the lowest, at 6.3%. Family physicians had an 11.4% move rate.