A question of timely retirement is not unique to the medical profession, but the issue of public safety can place more responsibility on doctors to make good decisions about when to retire.
For many doctors, considering retirement from a vocation that defines their identity, and accepting it, can be challenging.
Currently, there is no legal retirement age for doctors in Australia, but there is a body of research on the risks associated with older age for doctors. It is important, however, not to dismiss the qualities that age brings to the workforce; skill, experience and wisdom gained from decades of exposure to clinical medicine.
Fluid versus crystallised thinking
The evidence suggests older adults are poorer at fluid intelligence which compromises the ability to solve problems in novel situations and think flexibly, which may lead to difficulty recognising alternative solutions in a clinical case.1 In contrast, crystallised intelligence, accumulated knowledge through education and experience, does not diminish with age.1
Research by, Dr Rupert Sherwood and Dr Marie Bismark, from the University of Melbourne, on ageing surgeons found a quarter of the interview participants (13 of 48) recalled a specific case where they perceived patient safety was put at risk due to age-related changes in a surgeon’s performance.2
Based on his research and professional experience, Chanaka Wijeratne, an old age psychiatrist, who is an Adjunct Associate Professor at the University of Notre Dame, believes that between 60 and 70 should be the “amber light” for doctors to start the transition to retirement.
“Although I do not advocate a mandatory retirement age and the timing of retirement will depend on individual circumstances, retirement planning is multidimensional and should really begin when you are in mid-career. This is when you should start to consider how you will manage the transition and develop the resources to adjust to retirement,” A/Professor Wijeratne says.
Research also shows that patient outcomes may be poorer as the age of the doctor increases. A number of factors may protect doctors from developing dementia, but unfortunately many older doctors do develop mild cognitive impairment which can compromise safe practice.3
Retiring beyond the ‘amber light’ age
Dr Carol Ashford had been practising for 52 years, when she decided to retire in July 2019 at the age of 79. Finishing her career as a GP in a busy inner-city practice in Sydney, she says, “I decided to retire as I was becoming increasingly more stressed and found it difficult dealing with insistent patients.”
Dr Ashford is not alone in practising beyond the amber light age for doctors, As at 31 March 2020 there were 1,985 registered doctors over the age of 75 and 1,222 over 80.4
Working for a large GP practice group meant the transition for Dr Ashford was relatively smooth.
“Once I had decided to stop work it only took two weeks to finalise everything and it was pretty straightforward,” she says.
While Dr Ashford experienced a smooth transition to retirement, many doctors are conflicted over the idea of retiring from their vocation. Their decision to retire is as much an emotional decision, as it is a practical one.
A study found older doctors perceived that personal fulfilment from work, lack of outside interests, financial pressures and poor retirement planning all contributed to delayed transitions to retirement.2
For many doctors, their profession confers a strong sense of identity, making it hard to take the step into retirement. In an interview conducted by the researchers, one surgeon commented, “For a lot of surgeons, their work is their life and they won’t stop because they can’t see what to do when they hang the scalpel up”. There is no doubt, this sentiment resonates with many doctors.2
Planning is key
The transition to retirement can be challenging for some doctors and requires a lot of planning. However, being proactive can be beneficial. Here are ten tips to help you prepare for your retirement.
- Obtain financial advice to help you plan for your retirement.
- Design a structured retirement plan which includes the date of your retirement.
- Inform your colleagues about your retirement plan so succession plans can be put in place.
- Recognise your health limitations.
- Ensure you have allied health/administration support in the practice.
- Limit your hours and patient numbers.
- Cut out additional work such as nursing home visits, after-hours and house calls if you are a GP.
- Notify patients in writing about your retirement and the date this will happen.
- Identify patients who will require follow up.
- Familiarise yourself with your legal obligations on retaining, transferring or disposing of medical records.
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- EVA K. The Aging Physician. Academic Medicine. 2002;77(Supplement):S1-S6.
- Sherwood, R. and Bismark, M., 2019. The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons. BMJ Quality & Safety, 29(2), pp.113-121.
- Wijeratne C, Earl J, Peisah C, Luscombe G, Tibbertsma J. Professional and psychosocial factors affecting the intention to retire of Australian medical practitioners. Medical Journal of Australia. 2017;206(5):209-214.
- Medical Board of Australia - Statistics [Internet]. Medicalboard.gov.au. 2020 [cited 8 May 2020]. Available from: https://www.medicalboard.gov.au/News/Statistics.aspx