By EWA MATUSZEWSKI
‘Dr. Smith’, a specialty physician, retired during the pandemic. His office lease was up and the thought of committing to another five-year lease amid ongoing uncertainty seemed unwise. Did he move onto a life of golf, travel, and other leisure focused activities? Hardly. He didn’t move on at all. As a matter of fact, he was bored silly. It was an opportunity to switch fields and take on a new position at a local hospital that crystallized his thinking on retirement. Namely, he didn’t want to be retired – at least not yet.
I have plenty of other anecdotal stories of physicians who retired too soon. What I’m beginning to believe is that we can find a role for these retired-too-soon physicians. Admittedly, many do not want to return to their previous physician lives. The stress of running a private practice and its myriad details and push and pulls – especially the hiring and retention of staff and the many business details and uncertainties of self-employment – has permanently lost its appeal. And for those who were hospital-employed, the internal politics of health systems, a perceived lack of autonomy and the constant push to use more hospital services, keeps them from returning.
A consistent message I get from retired-too-soon physicians is they have capacity and miss their patients and the practice of medicine. But they don’t necessarily want to be in charge of anything “business-focused” anymore. And they may want remote-only options. Many don’t want to work full-time.
Enter remote work and the healthcare deserts of rural areas such as Michigan’s Upper Peninsula and Northern Lower Peninsula. The lack of primary care physicians in sparsely populated areas is well documented. The need for behavioral health providers in these areas is, too. It’s not hyperbole to say it’s a public health crisis in both specialty areas. Could recently retired physicians help fill the gap via telehealth?
Physicians could dedicate 10 to 20 remote hours a week in two to four five-hour increments to provide ‘intake’ on new patient care or augment an existing physician practice that can’t handle its patient load. Those with experience doing so could provide initial mental health assessments for patients who have scheduled appointments – or are trying to do so – specifically for a behavioral heath issue or substance use disorder.
Granted, not all remote residents have sufficient access to technology or wi-fi. But for those without laptops or smart phones, perhaps the existing physician offices could add private patient rooms that offer video portals to physicians outside the area. Or such portals could be provided in community spaces such as libraries or community buildings that have rooms offering privacy. With the level of grant funding available for improving access to healthcare innovation, I’m confident funds could be found to launch and sustain this type of rural health initiative.
Retired physicians often maintain their certifications and licensure. In my own experience with retired physicians, they continue to read medical journals and stay current on evidence-based medicine in their field, as well as pharmacological advances. Retired physicians willing to work may not seek it out but would be more than happy to consider opportunities to continue using their skills in situations where they could create their own schedule and work from the comfort of home.
Interestingly, as I was writing this column, I ran across an article in the Wall Street Journal on a recent survey looking at the effectiveness of older versus younger physicians serving as hospitalists, a subspecialty of internal medicine. While the younger physicians fared somewhat better in terms of decreased patient mortality (for a variety of potential reasons), an important survey finding was that the older physicians who fared best were those with a full patient load. It’s just one survey, but perhaps consideration of employing retired physicians would include those who retired in the past 18 months from a full-time position and are less than 70 years of age.
As Michigan ages and the corresponding need for care increases, we need to be creative in finding viable and sustainable solutions. Re-engaging retired physicians should be near the top of the list.