One-third of senior doctors are still working full time

CANADIAN INSTITUTE FOR HEALTH INFORMATIONApr 8 2011

More than 1 in 10 Canadian physicians is age 65 and older, but many doctors remain active in clinical practice after reaching the traditional retirement age, according to a study released today by the Canadian Institute for Health Information (CIHI). In 2009, 12% of the active physician population was at least 65, up from 9% five years earlier. However, one-third of doctors in their senior years were still working full time.

CIHI data also shows that older physicians no longer classified as full time still carried, on average, 40% of a full workload.

"One in five active physicians in Canada is over the age of 60. With so many doctors about to reach their so-called retirement years, some Canadians have expressed concern about whether they will continue to have access to the medical services they need in the coming years," says Michael Hunt, Director of Pharmaceuticals and Health Workforce Information Services at CIHI. "However, our study shows that physicians do not tend to retire, in the conventional sense, when they reach age 65. Instead, they slowly wind down their practice over the years. In addition, thanks to an influx of new medical school graduates, the number of active physicians working in Canada is on the rise, and the average age of physicians is stabilizing."

Older family physicians lessen workload, narrow practice

The report, Putting Away the Stethoscope for Good? Toward a New Perspective on Physician Retirement, found that rather than leave the workforce completely, many older physicians lessen the intensity of their clinical practice. In 2007, 7% of physicians age 55 and older, and close to 12% of physicians age 65 and older, became minimally active; that is, they worked 33% or less of their previous workload.

Although there were no major differences between family physicians in different age groups with respect to clinical activities, such as office assessment and mental health care, the older general practitioners became, the less likely they were to provide certain services. For example, fewer than 35% of female family physicians age 65 to 69 provided hospital inpatient care, compared with 59% of those younger than 40. Similarly, 56% of male family physicians age 65 to 69 provided services requiring advanced procedural skills, compared with 77% of those age 40 to 44. This shift in scope of practice was also evident in family physicians providing obstetrical and anesthetic services and happened faster among female physicians than among their male counterparts.

More physicians intend to retire than actually leave the workforce

According to the 2007 National Physician Survey, just more than 3% of all physicians reported that they planned to retire in each of the two years following the survey. However, CIHI's study found that estimates of actual retirement rates were significantly lower, with less than 1% of doctors (between 0.54% and 0.79%) retiring annually from the workforce in this period.

"In the physician workforce, retirement is not a sudden event," says Dr. Raymond Pong, a researcher at the Centre for Rural and Northern Health Research at Laurentian University and author of the study. "Instead, we see a transition to retirement, with doctors progressively taking on less work and carefully choosing the work that they do take on. It's a process that can extend over months and, in some cases, years. As the proportion of older physicians increases, understanding what they do, how much they do and how long they stay active is going to become very important for workforce planning."

Quick facts on physician retirement

• In 2009, one-third of physicians age 65 and older were still working full time.
• In 2009, there were approximately 68,100 active physicians working in Canada, one-tenth (12%) of whom were 65 and older, up from 9% in 2004.
• In 2007, more than 7% of physicians age 55 and older, and close to 12% of those age 65 and older, became minimally active; that is, they worked 33% or less of their previous workload.
• The older general practitioners became, the less likely they were to engage in such activities as hospital inpatient care, obstetrics, anesthesia and services requiring advanced procedural skills.
• In 2007, while just more than 3% of surveyed physicians reported that they planned to retire in each of the two years following the survey, the estimated average annual retirement rate was actually well under 1% annually.