A Systematic Review of Physician Retirement Planning

Abstract

IntroductionWhile Japan, parts of Europe and many low-and middleincome countries face concerns about physician shortages, [1][2][3] the physician workforce has been stable or increasing in other regions such as North America and the United Kingdom [4][5][6][7]. Among regions of growth and stability, the momentum of increasing physician supply has largely been driven by the sizable and growing number of physicians who have remained in or re-entered active practice beyond the traditional timing and retirement age of 65 [8,9]. Across OECD countries, nearly onethird of all practicing doctors were on average over 55 years of age (OECD, 2015). In Japan, the percentage of physicians 60 years and older are expected to increase from 20% in 2010 to 36% in 2035, suggesting that if remained unchanged current strategies may insufficiently address future demand for healthcare [10,11].Along with these demographic shifts are rising concerns that an older physician workforce will be faced with increasing cognitive impairment and associated dementia, as well as, physician burnout and deterioration of physical health potentially producing increased medical errors which put patients and quality of care at risk [12]. Physician retirement can also have a potentially negative impact on patient care as discontinuities in patient care can have implications for patient safety [13] and be particularly difficult for older patients who may be experiencing multiple losses [14].The abolition of mandatory retirement in the US has encouraged many physicians to extend their medical careers, while in Japan legislative exemptions to the physician profession have supported physicians in accumulating many decades of experience over the course of their working lives generating greater unpredictability of later career transitions [15,16]. Physician retirement planning A Systematic Review of Physician Retirement Planning AbstractBackground: This systematic review identified empirical studies to elaborate on the understudied aspect of retirement timing related to physician's preparation and engagement with the retirement planning process. Four questions were addressed: 1) When do physicians retire? 2) Why do some physicians retire early? 3) Why do some physicians delay their retirement? 4) What are some strategies that facilitate physician retention and/or retirement planning? Methods and Findings:English-language studies were searched in electronic databases through June 2015 to meet the following inclusion criteria: peerreviewed primary journal articles, published with quantitative or qualitative analyses of planning and opinions about physician retirement. Three independent reviewers assessed each study for methodological quality and a third reviewer resolved inconsistencies. In total, 60 studies meet the inclusion criteria and were analyzed. Representative sampling was used in 75% of studies, however most did not control for confounding variables. The majority were methodologically strong. Physicians commonly reported retiring between 60 and 69 year...