Retirement of primary care physicians is a growing concern given the shortage in the field, but recent research suggests that the rate at which these physicians are moving into retirement is holding steady, unaffected by recent changes in policy or the economy.
With baby boomers reaching retirement age and the increasing need for more primary care physicians to care for an aging population, researchers at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care sought to bring retirement figures into sharper focus. What they found is that primary care physicians who retired between 2010 and 2014 were 65 years old on average.
The study, titled "When Do Primary Care Physicians Retire? Implications for Workforce Projections,"(www.annfammed.org) was published in the July/August issue of the Annals of Family Medicine.
Researchers found that data do not support the suggestion from anecdotal reports that physicians are retiring early because of the burden of new federal regulations. The data were gathered from 2010 to 2014, the peak period when new regulations were introduced. On the flip side, there was no evidence that physicians might be delaying retirement because of recent economic downturns.
"Those narratives are out there, but in this snapshot, we don't see them," Winston Liaw, M.D., M.P.H., medical director for the Robert Graham Center and a co-author of the study, told AAFP News. "We're still concerned about attrition in the workforce and a leaky pipeline."
The percentage of retired physicians jumped from 4 percent among 60-year-olds to 12 percent among those age 65. At age 50, nearly all primary care physicians were classified as working in direct patient care, teaching, research or administration.
Using the 2014 AMA Physician Masterfile, the researchers identified 78,000 primary care physicians between ages 55 and 80 who were clinically active. But verifying the actual number of physicians who are retired is a challenging task, given that there is a wide gap between the number of physicians who are listed as active in the AMA database and the number in the National Plan and Provider Enumeration System (NPPES), which physicians were required to join in 2008 for most billing purposes.
Graham researchers discovered that the AMA file underreports the number of retired primary care physicians. For instance, it classifies an "improbably high" 40 percent of primary care physicians as still being in direct patient care at age 75. The researchers sought to correct the retirement undercount by overlapping data from the AMA and the NPPES.
Capturing career changes among physicians is difficult because the data do not reflect when a physician takes a nonclinical job. The researchers also noted that they cannot tell whether a physician stops seeing patients abruptly or moves to part-time status before retirement.
There were no appreciable differences in retirement age among various demographic categories or when comparing family physicians, pediatricians and general internists, although female primary care physicians had a median retirement age about 1 year younger than their male colleagues.
Liaw said that despite the frustration of new regulations and the burdens of documentation, primary care physicians generally are not leaving the profession earlier than expected.
"It's possible that physicians have not reached the tipping point," Liaw said. "We're not seeing that trend."
Liaw suggested it might take another three years to analyze whether payment reform and associated regulations influence the age at which physicians decide to retire.
The Graham Center is conducting another study using the American Board of Family Medicine database to delve deeper into the number of physicians who may have left patient care for a nonclinical position or may have left medicine altogether.