[White Paper] The Realities of Physician Retirement: A Survey of Physicians and Healthcare Administrators

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One of the major factors of the impending physician shortage is the aging physician workforce. We recently conducted a survey including practicing physicians and health administrators to better understand the situation. This whitepaper includes our findings and conclusions. Feel free to download and share.

 

By 2020, one in three physicians will be over age 65 and approaching retirement. For hospital administrators, recruiting an experienced physician is a complicated process that takes significant time. An open position is costly in terms of lost revenue and the potential loss of both patient satisfaction and staff morale.

Given that a hospital can easily lose $150,000 per month if a specialist leaves and that a search for a medical or surgical specialist takes five to 10 months, the stakes are high. New research from Jackson Physician Search―that surveyed both practicing physicians and healthcare administrators―highlights the importance of creating the right culture and processes around physician retirement, including effective transition processes and ongoing recruiting efforts, to avoid the negatives of a vacancy or understaffing situation.

Among the key findings:

  • Physicians’ drivers for retirement include lifestyle, financial stability, burnout and frustration with the current state of medicine. While physicians cited lifestyle issues (44 percent) as the most important reason driving their retirement decision, followed by financial stability (23 percent), comments from nearly 20 percent of them noted burnout and frustration with the increased focus on paperwork and patient volume as well as decreased focus on patient care.
  • Physicians feel it’s their responsibility to initiate the retirement conversation, but they are less comfortable doing so than administrators. A large majority of physicians (80 percent) said it’s their responsibility to broach the subject compared with 37 percent of administrators, yet less of them (52 percent) are comfortable discussing retirement plans than administrators (74 percent).
  • Physicians and administrators have vastly different opinions on what the ideal notice period is for a retirement timeline. Almost 50 percent of administrators indicated the ideal notice was one to three years, while 40 percent of physicians felt six months or less was sufficient. Also, 34 percent of physicians said they weren’t required to give any notice of retirement, while 81 percent of administrators said they were required to give more than three months.
  • Administrators assume that many physicians will fully retire, but a number of them plan to work elsewhere. Almost 40 percent of administrators named full retirement as a top retirement transition method at their organization, but just 17 percent of physicians were planning to do so. In contrast, 28 percent of doctors say they will work part or full time somewhere else.

Although there is hesitancy about initiating a conversation about retirement, it is clear that both administrators and physicians feel that it’s a beneficial discussion for both parties. Differences remain on length of notice and whose responsibility it is to bring up retirement, but when handled respectfully and conducted in a non-discriminatory way, both parties can find the ideal way to transition the retirement with proper planning and processes.

Survey Methodology and Demographics

To find out how both physicians and hospital administrators approach physician retirement and transition planning, we surveyed both groups on a range of related topics. These included the age of retirement, drivers for making the decision, requirements and timeframe for giving notice, comfort with having the conversation and whose responsibility it was to initiate it. Other questions were related to the retirement transition itself and interest in employer retirement incentives.

A total of 567 physicians and surgeons from a wide range of specialties responded to the survey. Physician respondents were distributed throughout the United States, roughly based on state population. Half of them described their communities as suburban and just 15 percent noted rural. Most respondents (61 percent) were between the ages of 50 and 69, and the majority were male (71 percent).

There were 100 hospital administrator respondents to the survey, many of which were C-level executives, followed by directors and administrators in a variety of recruiting and human resources functions. The administrators were distributed across the country, but a larger proportion (40 percent) were from self-described rural communities. As with the physician respondents, most were between the ages of 50 and 69 (63 percent), although the majority of administrator respondents were female (55 percent).

Drivers for Physician Retirement

In the survey, administrators report the average age for retirement at their healthcare facility as 65, which is in line with the age of 63 as determined by analysis of U.S. Census data. Not surprisingly, physicians named lifestyle (44 percent) and financial stability (23 percent) as top drivers for retirement. Likewise, administrators also perceive lifestyle (48 percent) as a top driver, although they found health reasons (15 percent) the second most prevalent motive, which was close to three times more than what physicians cited. Administrators were also less likely to think that financial stability (14 percent) was the most common reason physicians made a retirement decision.

More than 17 percent of physicians indicated “Other” as the top reason for retirement, compared with just 10 percent of administrators. Many physicians indicated burnout and frustration with the state of medicine in the United States, as noted in the following comments:

  • Managed care, whether private or government, has made the practice of medicine too adversarial to enjoy enough to consider delaying retirement.
  • Medicine has turned into a quagmire of regulatory burdens, collecting data, and the destruction of physician’s autonomy and authority in individual patient care.
  • Doctors are no longer able to practice medicine with the primary objective of patient well-being!!
  • It has become too onerous to practice. The focus is on increasing volume with less and less pay. Also, the practices are running leaner which shifts more and more clerical work onto doctors. Add to these issues the increasing testing and “boutique” results reporting and you have a formula for high stress with diminishing satisfaction and diminished returns.

Having the Retirement Conversation

When it comes to initiating the retirement conversation, survey results show that the topic weighs more heavily on the physician, and that there is room for administrators to make the discussion more comfortable, both for the benefit of the physician and the organization. A large majority of physicians (80 percent) said it’s their responsibility to broach the retirement subject compared with 37 percent of administrators, yet less of physicians (52 percent) are comfortable discussing retirement plans than administrators (74 percent). One physician noted that “succession should always be a part of the hiring discussion and empowerment to plan and mentor over time.”

On the administrator side, almost 30 percent cited “Other” when asked whose responsibility it was to start talking about retirement. The following comments from physicians in this category indicated an acknowledgment that they had difficulty broaching the subject―and that there is a need for a more formal, yet inviting process, especially given the long lead time needed to recruit a physician:

  • MDs usually initiate, but if they are having trouble, the administrator or group president will initiate the conversation.
  • I believe our physicians are not very comfortable with the conversation, so we (HR) have provided them with a script and talking points to assist with these conversations.
  • Ultimately, it should be the physician, but there is a hesitancy to do so. Therefore, we have tried to make it a collaborative discussion between the physician and the physician leader.
  • We periodically send surveys to the physicians, asking that they let us know if they are considering retirement in the next 1 to 3 years, as the recruitment process is lengthy.
  • The organization views it as the physician’s responsibility. However, as a recruiter needing lead time, I’d like a plan to approach the physicians and have administration address succession planning. I’ve been pressing for this almost five years without success.

The Realities of Giving Notice

Physicians and administrators have vastly different perspectives on what the ideal notice period is for providing a retirement timeline, a finding that might partially be explained by the lack of conversation and practices regarding retirement in general. Almost 50 percent of administrators indicated the ideal notice was one to three years, while 40 percent of physicians indicated it was 6 months or less. Also, 34 percent of physicians said they weren’t required to give any notice of retirement at all, while 81 percent of administrators said they were required to give more than three months.

When administrators were asked how much notice they typically receive when a physician plans to retire, their answers ranged from a high of three years to a low of one month, with an average of 10 months. The most common notice period cited was six months, which was in line with what physicians reported as the ideal notice period. Given the timeline for locating a physician and the fact that 40 percent of physicians thought 6 months or less was an ideal notice, administrators should consider the practice of ongoing recruitment of candidates to make sure there are no gaps in care and revenue.

The Retirement Transition

Physicians in the survey indicated some differing ideas about the retirement transition than administrators might assume, which possibly indicates they are looking for greater flexibility in their transition process. Almost 40 percent of administrators named full retirement as a top retirement transition method at their organization, but just 17 percent of physicians were planning to do so and almost 28 percent of doctors say they will work part or full time somewhere else. Some of the doctors listing “Other” planned to pursue locum tenens work or pro re nata (PRN) and telemedicine options that let them dictate their own schedules, while others looked to potentially help with recruiting, mentoring and managerial tasks at their current practice.

Many physicians (47 percent) were interested in retirement information planning services, but only half of administrators indicated those are offered. Comments from physicians indicated the vast majority of them were, not surprisingly, most interested in financial and healthcare planning. Physicians in the survey were also looking for help with the general process of retirement, along with ways to explore part-time or non-clinical options, as noted in these comments:

  • There is a need for an outline and timeline of what needs to be done, as well as the contact people to facilitate the process.
  • I would like to know the steps for the retirement process and how/when to transition to Medicare health coverage. I am also interested in opportunities for part-time work with the same employer, along with pay/benefit information.
  • It would be helpful to know how to manage before full retirement age.
  • I would like to know what part-time work is available once I retire that may or may not include clinical care.

When asked if employer-sponsored incentives would induce them to start an early retirement process, 50 percent of physicians agreed it would, with most requesting financial and/or healthcare benefits. Others were looking for part-time employment opportunities. However, nearly all administrators (95 percent) indicated they offered no incentives to initiate an earlier retirement approach so that staff planning was more seamless.

 

 

Conclusion

The survey results indicate that there is a need for more formal processes surrounding physician retirement, especially given the ongoing shortage of doctors in the United States. To help both hospitals and physicians with the retirement transition, administrators should:

  • Develop non-discriminatory ways of approaching the retirement conversation. HR and physician leaders should work together to create a step-by-step process for when and how to approach the conversation, which might even occur as early as during the hiring process. Having such a process makes the physician feel less singled out for the discussion. In addition, routine surveys on retirement plans can open the lines of communication.
  • Offer incentives to initiate an early retirement process. To encourage earlier notice of retirement from physicians, administrator should consider incentives like a percentage of pay for earlier notice, health benefits for a specified time period, and relief from call duties.
  • Create flexible offerings like part-time or non-clinical work. For financial and other reasons, such as benefits, many physicians would like to continue working, which could ease the burden during the onboarding process for a new physician. Having a process for scheduled conversations about retirement can help prepare for a situation where several physicians retire at once, which would include extra scheduling activities and other administrative tasks. However, given the high costs of a full vacancy, these costs could easily be justified.
  • Adopt a continuous recruitment process instead of treating a physician vacancy as a one-off occurrence. This will ensure that the physician candidate pipeline is full in the event that one or more physicians are transitioning to retirement. By maintaining relationships with qualified candidates, the organization is not starting at the ground floor of recruitment and can quickly adjust to unforeseen issues with retirement transitions.

With the proper planning and processes built on more open communications, hospital administrators can avoid understaffing and continue to provide the best possible patient care. Starting early in a physician’s career with these processes can make the transition and succession planning more comfortable for all parties and support more optimal recruiting efforts.

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[White Paper] Rural Recruitment: Results from the 2019 Rural Physician and Administration Survey

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President of Jackson Physician Search, Tony Stajduhar, reviews the results of our recent rural physician and administrators survey and provides a summary of action items administrators should consider when recruiting physicians to their community.

Rural Physician Recruitment: Results from the 2019 Rural Physician and Administration Survey

By Tony Stajduhar, President, Jackson Physician Search

The Current State of Rural Physician Recruitment

The number of physicians practicing in America’s rural areas is on the decline. From 2013 to 2015, the overall supply of physicians in the United States grew by 16,000 but the number of rural physicians declined by 1,400. These facts compound the problem that while 20 percent of the U.S. population is rural, only 12 percent of the primary care physicians work in a rural area. This survey reports the results from the perspective of rural hospital administrators and rural physicians. The insights lead to recommendations which may help with this growing disparity.

With all of the data trending in the wrong direction for rural healthcare administrators, the challenges of recruiting and retaining physicians to work in rural communities have reached new levels of urgency. In a perfect world, rural health systems would be able to allow the free market to dictate what they can offer physicians to practice in non-metropolitan areas, but that isn’t the case.

Many rural health administrators have had to address physician recruitment in more creative ways than just offering more compensation. However, a recent survey sponsored by Jackson Physician Search has identified that a gap exists between what administrators think is important to their physicians versus what the physicians claim are important to them.

This paper will review the results of what rural physicians say is essential to them in their practice setting in contrast to what rural health administrators identify as important to their physicians. Lastly, we will provide a summary of action items that rural health system administrators should consider when recruiting physicians to their community and what they need to do to keep them engaged.

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[White Paper] Issues Affecting FQHCs: What will it take for Federally Qualified Health Centers to survive in today’s healthcare physician recruiting climate?

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Physician vacancies are affecting the majority of health centers across the country. This paper examines some of the recruitment and retention challenges that Federally Qualified Health Centers are facing and how to overcome them. Feel free to download and share.

Issues Affecting FQHCs

What will it take for Federally Qualified Health Centers to survive in today’s healthcare physician recruiting climate?

Jackson Physician Search in Partnership with CommonWealth Purchasing Group

A vast majority of all health centers are reporting a clinical and physician vacancy. Over the years, health centers have evolved to provide much more than primary care services in their community, but we are entering a critical time, and the shortage of physicians and clinicians overall is set to make a massive impact in the world of Community Health.

This paper examines some of the challenges that centers are facing today regarding recruitment and retention. Staffing shortages and difficulty in attracting physicians are overcome through a proactive and strategic approach to recruitment. Today, two of the top challenges are the shrinking candidate supply and changing compensation trends.

Neither of these issues are insurmountable, but they are a driving force in changing the community and rural health center model.

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[White Paper] Physician Recruitment: The Cost to Hire and Return on Investment

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Physician Recruitment: The Cost to Hire and Return on Investment

by Tony Stajduhar, President, Jackson Physician Search

Healthcare organizations depend on recruiting and retaining physicians and advanced practice providers to support their mission to offer quality patient care. A critically important vacancy can be costly to the organization, patients and community as a whole, impacting healthcare delivery, quality of life and the local economy. 

Maintaining continuity of quality care is of chief importance. Yet, a sense of urgency to fill a costly vacancy must be combined with a clear understanding of how investing in a strategic recruitment process can accelerate the fill and reduce the risk of making a poor hire. 

Return on Investment is a straightforward concept that is familiar to leaders in healthcare’s outcomes-driven environment. Yet, in the area of recruitment, many organizations lack a structured method and accountability for measuring recruitment success, efficiency and return on investment. Too frequently, recruiters do not know if their definition of recruitment success is the same as their boss’s or the board’s. As a result, there is no formalized process to measure efficiency and maximize results. 

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[White Paper] Physician Workforce through 2030: Social Media for Physician Recruitment

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Physician Workforce through 2030: Social Media for Physician Recruitment

By Tony Stajduhar, President, Jackson Physician Search

The physician shortage continues to rank among the top three concerns for hospital CEOs, making the need to cost-effectively recruit the right candidates more acute than ever. As the physician workforce evolves, how can your organization recruit faster, more efficiently and at less cost? Embracing social/digital media as a core strategy has become central to recruitment success.

Social Media is at the Intersection of Two Key Physician Behaviors

Physicians are networkers. Through their years of training and beyond, physicians build large personal and professional networks they trust. Physicians rely on these networks for many professional reasons including building practice networks, keeping up with industry trends and news, and opening doors to future practice opportunities.

Physicians are digital omnivores. Their hunger for connectivity keeps them constantly connected through multiple devices, including laptops, tablets, smartphones, and even wearables. Technology keeps physicians, like the rest of us, connected 24/7, both personally and professionally.

Peer-to-peer communication is changing with the rise of physician engagement on social networking platforms. A survey published in the last couple of years reported that 65% of physicians use social media for professional purposes, a number that has surely grown as dedicated physician resources and communities have developed to meet physicians where they are: online.

For example, NEJM Resident 360 connects them to experts for clinical and career insights as well as a supportive community of fellow residents. Another example is SERMO, a self-described “virtual doctor’s lounge.” It was created for verified and credentialed physicians to talk openly with other physicians about the business and practice of medicine.

Doximity is another example of how social media interaction among physicians is growing. As a HIPAA-compliant smartphone application with over 70% of US doctors as verified members, their technology enables doctors and other healthcare professionals to connect and securely collaborate on patient treatment, grow their practices and discover new career opportunities.

Read the rest of this whitepaper by clicking the download button.

 

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[White Paper] Physician Workforce 2030: Getting Ahead of the Recruitment Curve

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The physician workforce shortage creates a competitive recruitment marketplace. This white paper offers practical advice on what to do today to focus your recruitment strategy for long-term success.

 

Physician Workforce through 2030: Get Ahead of the Recruitment Curve

There’s been heavy discourse the last few years about the growing physician shortage in the United States. Based on a recent detailed study, the Association of American Medical Colleges (AAMC) now projects a shortage of between 40,800 and 104,900 physicians by 2030.

A complex set of assumptions factor into the models resulting in projected shortage that vary in degrees of magnitude depending on the location, specialty and population served.

The Affordable Care Act has helped push the percentage of insured Americans to nearly 90 percent, creating a greater need for primary care physicians to see new patients.

At the same time, uncertainty around healthcare legislation and the sheer complexity of reimbursement is enough to steer many physicians – both aspiring young doctors and those with years of experience – away from patient care.

Our population is shifting older; the Census Bureau project that the population 65 years and older will become larger than the population under 18 years old by 2056. And while America ages, so do its doctors. Nearly 30 percent of active physicians are now over the age of 60.

Specialties with the Greatest Demand

Family Medicine, Internal Medicine, and Psychiatry

Jackson Physician Search compared open jobs by specialties from ten top job boards and compared them to the number of third-year residents for those specialties, as provided by MMS data. Assumptions that played into our research model: The turnover rate for doctors hovers around 6.8 percent, according to the American Medical Group Association. We recognize that retirees – and practicing physicians who change jobs – both leave vacancies that will most likely be filled fro the pool of graduating residents. Some are advertised on multiple job boards, while others are not advertised at all.

Based on this analysis, the specialties with the greatest demand are: family medicine, internal medicine, and psychiatry. Young medical students are forgoing these for more technical specialties that result in more defined hours, high mobility, higher incomes, and the perception of greater prestige than primary care. The stigma of mental health may be a factor in turning medical students away from psychiatry, in which only half of residency programs in the U.S. are filled, according to Dr. Adam Brenner, a psychiatrist and associate professor at UT Southwestern Medical Center.

The Disparity of Physician Workforce Coverage

Not only are there not enough doctors to go around, they aren’t evenly distributed. The resulting barriers to accessing specialty care creates significant – even tragic – disparities in health and well-being among many rural Americans.

Nationally, there are, on average, 91.1 active primary care physicians per 100,000 people, but some states fared better than others, according to the AAMC, which based their distribution map on census and American Medical Group data.

 

Read the full whitepaper by clicking the download button.

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