Career Development

Harnessing senior physicians' expertise: Taking on new roles

Older physicians—especially those who are still interested in actively contributing to health care after retirement—have invaluable knowledge to pass on. Find out what one physician has to say about the profession finding new ways for these doctors to impart what they’ve learned.

Creating new opportunities

Late-career physicians need pathways that let them pursue professional mentoring, teaching and meaningful community involvement, such as volunteering or working with service agencies or communities that are important to their organizations, a Mayo Clinic Proceedings commentary urges.

Older physicians are less likely to be motivated by financial considerations and more likely to be looking for other rewards. Consequently, alternatives beyond cutting back their hours could help them “rediscover meaning and purpose in medicine and potentially prolong careers,” writes commentary author William M. Spinelli, MD, a researcher at Allina Health’s Division of Applied Research in Minnesota.

“In return for this engagement, organizations would reap the benefit of the accumulated institutional wisdom and increased community engagement from senior clinicians as they continue medical practice and bridge the interval before the arrival of new primary care practitioners,” he said.

A different way of thinking: From early exits to new roles

Long work hours, productivity demands and professional fatigue are driving a number of physicians out of practice earlier than they expected. Adding to the stress for some physicians is a growing number hospitals and practices requiring older physicians complete evaluations to see if they are still competent to practice.

A 2014 Physicians Foundation study found that 44 percent of physicians surveyed planned to make changes that would ultimately reduce patient access to their services, including cutting back on the number of patients seen, retiring or working part time.

Those statistics come at a time when primary care is facing a projected physician shortage. For years, fewer medical graduates have been choosing to go into primary care specialties such as family and internal medicine. At the same time, the U.S. population is living longer, resulting in more people needing care.

“A great deal of the health care system is focused on innovative practices and such things as work flow processes and payment reform,” Dr. Spinelli said in a video accompanying his commentary. “I would suggest that another form of innovation is investing in the people who are responsible in helping with both patient care and implementation of these other new health care system design strategies.”

Dr. Spinelli suggests that medicine can learn something from heartwood trees. As the trees age, the older cells at the core of the tree harden when they lose some of their ability to conduct water. As they harden, they perform the essential function of structurally supporting the tree.

“Specifically, the question at hand is, ‘How can we leverage the knowledge, wisdom and experience of senior physicians at a time in their career when they are struggling with the pace, demands and changes in health care?’” Dr Spinelli said.

He suggests that physicians can explore their commitment and passion for medicine and their communities by asking:

  • How did I get to this stage of my career?
  • What do I want the next stage of my career to look like?
  • What are the skills needed and the possibilities available for this next stage?
  • How can I learn from and share these journeys with colleagues?

Tackling senior physicians’ concerns

The AMA earlier this year convened a national group of stakeholders to explore the growing trend of assessing the competency of aging physicians. The group, which included nearly three dozen representatives from organizations such as the Joint Commission and the Council of Medical Specialty Societies, was a recommendation of a recent report from the AMA Council on Medical Education.

The AMA Senior Physicians Section, which stands more than 55,000 members strong, was the driving force behind the AMA policy that led to the council report and the convening of the stakeholder group.

The AMA does not have a policy on whether physicians should be assessed, and the group began deliberation around key issues and challenges for determining whether national guidelines for assessment should be developed. Considerations include the legal implications of screening physicians based on age and the uncertainty of how to interpret cognitive or motor function tests given to physicians.