Economy disrupts doctors' retirement plans

Matthew Rice, MD, a 62-year-old emergency physician in Seattle, thought he would be firmly in retirement by now after leaving private practice earlier this year. However, Dr. Rice, like a lot of physicians his age or older, is finding himself still needing paid work.

"My retirement doesn't look as good as it did," said Dr. Rice, who is working six shifts a month at various hospitals on an as-needed basis. "This is similar for a lot of physicians I know. Many are making decisions to work a bit longer."

According to a survey issued Aug. 2 by the physician staffing agency Jackson & Coker, 52% of the 522 doctors responding had changed their retirement plans since the 2007-09 recession. About 70% of those changing plans said they will work longer until retirement because personal savings had been gutted or had not grown as rapidly as anticipated. There was no significant difference by specialty.

"This has hit physicians all across the board," said Sheri Sorrell, market research manager for Jackson Healthcare, the parent company of Jackson & Coker.

However, some said they were leaving medicine earlier than planned, including stepping down to part-time positions, partially because of economic changes in practice life. Of those leaving full-time medicine earlier than planned, 26% said it was due to uncertainties about health system reform. An additional 25% said they no longer enjoyed the work, and 22% were retiring early because of the rising cost of doing business.

"Some physicians have become discouraged because of their 401(k)s and health system reform and say that they are going to go do something else," said Ed McEachern, vice president of marketing for Jackson & Coker, referring to physicians who delay retirement or leave medicine early. "A lot of them are giving up on private practice. They're becoming employed by a hospital or working locum tenens or doing something else."

Of those who completed the Jackson & Coker survey, 26% planned to keep going at their job in their practice setting, but 32% planned to work locum tenens or part time. An additional 19% wanted to move to another permanent position within medicine, and 19% said they would leave the industry and look for something new.

"Most doctors still have to work for a living," said Gregory L. Henry, MD, 64, an emergency physician and past president of the American College of Emergency Physicians. "We're seeing doctors shift jobs but not stop working." He no longer sees patients, although he continues to teach and lecture.

Physicians retiring early or late are not doing so just because of stock market gyrations, including dramatic swings in August. Physicians may have decided that declining payments and the added expense of installing electronic medical records requires staying in practice longer.

Dr. Rice, who also has a law degree, had planned to continue practicing medicine on a volunteer basis. But after watching his retirement funds fluctuate wildly, he said he realized that he needed the security of paid work. He said he isn't sure when he will be able to retire for good.

But for Dr. Rice, this is not necessarily such a bad thing.

"I like to keep busy," he said. "I'm not that disappointed. I probably will be working more than I want to, but I probably would be working some anyway."

In the Jackson & Coker survey, 11% of physicians who said they will work longer before retiring will do so because they enjoyed the work. Also, older doctors are finding themselves in great demand because of a looming physician shortage and the millions of newly insured expected to come to medical offices because of health system reform.

Other surveys have suggested that physicians are finding ways to extend their working lives. Ten percent of physicians working part time are older than 65, according to the 2010 Physician Retention Survey by Cejka Search and the American Medical Group Assn. released April 16. An additional 21% of doctors 55 to 64 also were working part time. The number of male physicians working part time increased more rapidly than the number of women doing so. The authors of that report theorized that this was the result of senior male physicians putting off retirement but pulling back on work hours.

But this shift away from retirement is not just for financial reasons. There are also demographic changes. The average person who is 65 years old today tends to be healthier than the seniors of a few decades ago.

"To a great degree, we like being doctors," Dr. Henry said. "It's an interesting profession. We don't want to go home and play shuffleboard. And as medicine has gotten better, the 65-year-olds of today are not the 65-year-olds when I was a kid. We have got 65-year-olds running marathons. We're still pretty productive, and the concept of what constitutes retirement is going to change. I consider retirement to be 'the r-word.' I hate the 'r-word.' "