More than 40% of urologists to retire within decade

More than 40% of urologists to retire within decade

 

 

A new, nationwide survey of U.S. physicians shows that 42% of urologists say they will retire by 2022.

Overall, 34% of physicians say they will leave the practice of medicine in the next decade. In 2012 alone, 16% percent of physicians are going part-time, retiring, or leaving medicine, or considering retiring or leaving medicine, according to the survey conducted by Jackson Healthcare, a health care staffing company in Atlanta.

“Physicians are retiring in large numbers just as baby boomers are starting to turn 65,” said Richard L. Jackson, of Jackson Healthcare. “That creates a real health care access problem. Many are demoralized and weighing their options.”

The primary reason physicians cite are economic and political: medical malpractice and overhead costs closely followed by not wanting to practice medicine in the era of health care reform. Fifty-six percent cited economic factors for retiring or leaving medicine in 2012, while 51% cited health reform. The survey was conducted prior to the Supreme Court’s ruling on the Affordable Care Act.

Not all of the physicians who were considering leaving medicine this year were older. Of those who said they would leave the practice or are strongly considering so by the end of 2012, 55% were under the age of 55 years. Those physicians also reported that the cost of running a practice was too high and that they didn’t want to practice medicine in the era of health reform.

Fifty-seven percent of oncologists and hematologists and 49% of general surgeons said they would retire by 2022.

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Affordable Care Act brings influx of patients

Affordable Care Act brings influx of patients

Law’s impact forever changes healthcare financing and access to careAffordable Care Act

With the U.S. Supreme Court’s landmark decision to allow most of the Affordable Care Act (ACA) to stand, tens of millions of patients are about to acquire health insurance in 2014, some for the first time. This represents a monumental change in our nation’s approach to healthcare delivery, and it will forever change the financing of medical care. But with a shortage of primary care physicians (PCPs), many doctors are uncertain about its initial effect on primary care and the future of it.

Glen Stream, MD, MBI, FAAFP, president of

the American Academy of Family Physicians (AAFP), agrees.

 

This has been shown to be the case in Massachusetts, where a study by the Blue Cross Blue Shield of Massachusetts Foundation found that the use of emergency rooms for nonemergency reasons declined 4% from 2006 to 2010 (see Massachusetts case study).

Stream knows that primary care is already at capacity in many parts of the United States, especially family medicine. An AAFP study in 2000 found that a national shortfall of 3,900 family medicine practitioners will occur by 2020. The Association of American Medical Colleges (AAMC) estimates a national shortfall of more than 90,000 physicians across all specialties by 2020.

“By 2014 [when the new laws fully take effect], thousands of family practitioners aren’t going to suddenly appear,” Stream says. But an estimated 32 million new patients will.

The increased demand could bring new attention to solving the problem, Stream adds. The AAFP advocates for issues such as how to get more medical students interested in family practice and help them cope with the lower salaries while facing burdensome debt and achieve higher reimbursement, he says.

Richard M. Dupee, MD, chief of the geriatrics service at Tufts Medical Center in Boston and governor of the American College of Physicians’ Massachusetts chapter, sees the aging workforce as another major problem.

“Some older physicians are retiring rather than bothering with the requirements to adopt electronic medical records, and they are not being replaced by younger ones,” he says. “In rural areas, there are fewer of the academic hospital-owned clinics to take up the slack.”

Massachusetts is in the process of trying to fix another disincentive to primary care careers: low reimbursement. A bill is pending in the state legislature to raise payments. Nationally, the Centers for Medicare and Medicaid Services recently announced plans to give family physicians, internists, and others providing primary care a raise, too. But the trend for doctor reimbursements has been going down, and it may likely get worse for some.

“If reimbursement is fair, physicians with capacity will welcome [newly insured patients], but if it is not adequate, they will not,” Dupee says. “Most seasoned physicians in their 50s or 60s are already maxed out. They can’t absorb more volume without more money to cover the extra staff they will need.”

ADVOCACY

The AAMC notes that U.S. medical schools have complied with requests to boost class sizes by 30% time over the past 6 years, but the overall supply of U.S. physicians cannot expand unless Congress increases the number of federally funded residency training positions, a number that has been frozen since 1997.

“The AAMC is working hard to revisit this freeze,” says Christiane Mitchell, director of federal affairs. “Staying where we are will leave U.S. medical school graduates without a training position. This is an immediate issue.”

She notes that there is no real policy justification for the freeze; it was merely a victim of budget-cutting. The possibility of further federal cuts also has been raised.

“Medical school graduates need a place to train. Without one, it limits their options and may discourage the best and the brightest from choosing medicine as a career,” she says.