Separations
from the Physician Workforce
Physicians leave the workforce through retirement,
mortality, disability, and career change. An accurate estimate
of separation rates is crucial for projecting physician
supply when a large number of physicians are approaching
retirement. The PSM combines estimates of physician retirement
rates with mortality rates for college educated men and
women in the United States obtained from the Centers for
Disease Control and Prevention (CDC) to estimate the probability
that a physician of a given age and sex will remain active
in the workforce from year to year.
Concerns
that the current AMA Masterfile overstates the likelihood
that older physicians are still active prompted consideration
of two alternative sources of retirement rates: the Physician
Worklife Survey (PWS) [4]
and the Current Population Survey (CPS)
[5]
. Retirement
rates estimated with AMA Masterfile data from the early
to mid 1990s were found to be relatively consistent with
rates estimated with PWS and CPS data. We use the AMA-based
retirement rates in the PSM (Exhibit 4). We obtained much
lower retirement rates when using more recent data from
AMA, and concluded that the process AMA currently uses to
update its records results in a lag between when a physician’s
activity status changes and when that change is recorded
in the AMA Masterfile. Furthermore, activity status is self
reported, and some retired physicians might fail to respond
to the AMA survey. Recognizing this problem, the AMA automatically
recodes as retired all physicians age 75 and older who fail
to respond to its survey and all physicians who receive
AMA retirement benefits. For our projections, we assume
that that all physicians retire by age 75.
The
data suggest that physicians continue working to an older
age than do people in other professions. Other analyses
not presented here find that female physicians retire slightly
earlier than do male physicians.
Exhibit 4. Percent
of Physicians Active in the Workforce, by Physician Age
[D]
Anecdotal
evidence and economic theory suggest that retirement patterns
will fluctuate due to changes in economic factors and physicians’
overall satisfaction with the healthcare operating environment.
For example, recent declines in the wealth of physicians
due to adverse economic conditions and a decline in practice
valuation might delay retirement plans for some physicians.
For modeling purposes, we focus on long-term trends that
affect retirement patterns (e.g., the increasing number
of women in the physician workforce) rather than factors
that cause short-term fluctuations in retirement patterns. |
