Home
Print
E-mail
Reprint

 
Those of us in the later stages of our full-time emergency medicine careers are asking what seems like an increasingly important question: ‘Is there life after EM?’
 
There are questions about the end of one’s career as an EP that cannot be avoided. What roles will we play beyond the emergency department? Will we continue to see patients? In what capacity? What are our post-retirement work options and plans?

Last month’s EPM cover story highlighted the retirement challenges EPs are facing in the nation’s recent economic downturn. With dwindling retirement portfolios, some physicians said they were planning to postpone early-retirement to work longer in the ED, while others were exploring part-time patient care roles outside the ED.

For many physicians, the looming recession forced us to think about prolonging our work lives in the years ahead, and during a time when more patients are in need of more acute care.

The “Life After Emergency Medicine” survey was distributed to emergency physicians nationwide and EPM received 91 responses. The survey reveals that more than half of us have a professional care plan for ourselves: Of the 51 EPs surveyed who were over 50 years old, 54% said they had an “exit strategy” from their full time EM career.

For this story, we’ll focus on respondents in the over 50 age bracket. 23% reported their post-retirement plans included a move into urgent care. With increasingly overcrowded EDs, perhaps the option is more attractive than grueling frontline EM work through our golden years. Other respondents said they would plan to take fewer shifts, become an administrator, or pursue locum tenens. 

However, urgent care medicine isn’t simply a retirement “exit strategy”-- for 53% of respondents over 50, urgent care is viewed as an attractive career move for the “evolving emergency physician.” Other popular, post-retirement possibilities include:
“Walk-in clinics”
“Sports medicine”
“Flight medicine”
“Cruise medicine”
“Research”

The survey also asked readers to suggest career options for a “recovering” emergency physician – EPs who, for health or other reasons like burn-out, feel a need to move beyond full-time, frontline ED work. Answers ranged widely from the more serious (“Is there any other career?”) to the lighthearted (“become a Starbucks barista”), and many answers in between: “become a pharmaceutical rep”, “work for the FDA”, and “join the military.” 

The Middle East adventures of EPM’s own publisher Mark Plaster, who is serving as a military physician in Iraq, might have spawned the latter response. But not everyone is made for military mode, especially as we near retirement. 

But the most frequently cited career advice for recovering EPs was to pursue an educational position.

According to the American Medical Association, the average age of retirement for physicians is 62. It’s not yet clear if EPs will end up working later into life given current economic pressures, but it seems likely that more of us need to consider working in different care roles or contexts.

Nearly 75% of survey respondents said their group does not have designated night coverage at present or allow for reduced night shifts or other schedule  conciliations for group members after a certain age. So although most EPs surveyed are nearing retirement and roughly half say they have an “exit strategy,” fewer EDs, according to the survey, seem to be considering how the reduced ability to handle night shifts as they age will affect work strategy. 

Survey respondents said the average age of the oldest doc in their group is 60 years; the average age of the oldest doc they know is 64.

As with any survey, we’ve raised as many new questions as we’ve answered. One important topic to address moving forward: What kind of financial adjustments are EPs making to prepare for retirement? Last month’s issue included top financial tips to prepare a workable retirement strategy. But there are other issues to consider: what health insurance coverage will carry us into the twilight?  Will some of us end up depending on EMTALA, the very thing that may have driven us from the specialty?   
So the short answer seems to be “We THINK there is life after EM”.  We HOPE we can defer that decision as long as possible by remaining “in the business” or at least nearby. We don’t seem to have much help in this endeavor.  Do we want to learn more?  You tell us.  

Louise Andrew, MD, JD, is a past chair and the senior member of the ACEP Wellness Committee. Dr. Andrew founded the web site mdmentor.com
 

Comments   

# Survey: There is Life after EMPatrick Kelly, MD,, FACEP 2008-12-04 09:24
This is useful information. Just the fact that I know others are contemplating these same issues gives a boost to my psyche. At 51 y.o., I'm not alone looking for the light at the end of the tunnel; yet I'm not ready to quit completely. Thanks.
Reply
# DONatalie Painter 2008-12-04 11:45
It would be interesting to see an article from the perspective of those ER physicians who have moved on to "life after ER." Tracking down a few "retired" ER docs and gaining their perspective could provide an interesting viewpoint on this discussion.
Reply
# James Eutzler D.O., FACOEP,FACEP 2008-12-04 12:10
I "retired" from the ED after 28years of being the contact holder, director and shift worker. I r "retired" to an Urgent Care/Occ Med office as an employee of a hospital. It is an ideal situation with out the stress,night shift work, weekend work or holiday work.I now have time to enjoy myself and family and hobbies.The income is less but not by much when you take into account the benefits provided but that does take some adjustment. I miss the academics and medical challenges but not the stress at this stage of my career. I'd highly recommend this avenue for ED docslooking to get out of the ED.
Reply
# Life after EM?Jean Abbott 2009-02-02 15:33
I have just "retired" from my academic position in EM -- a total of 33 years in EM. I'm still practicing, but letting myself chase some other passions too. Is this survey still ongoing? Sounded like it was continuous, but I can't find it. :-) Jean
Reply
# Jon K. Jones, MD FACEP 2009-02-08 14:25
I am fortunate to be part of a group that recognizes the value of "older experienced" physicians and has incorporated changes to enhance longevity. The option of working 8 hour shifts, reduced nights, reduced minimum hours for benefits and overall increased physician and mid-level coverage make a real difference. One of our physicians is 70 and still working full time.
Reply
# Life After EMMichael LaFemina, MD 2009-02-25 02:56
At 58 I just went out on Full Early Retirement program from Southern California Permanente Group after 25 years with them. I was the founding and first chief of service at their Woodland Hills Facility for 7 years and after that a pit doc. Before that I had my own contract for 4 years for a total of almost 31 years full time ER. I am now working 50% still with SCPMG in Fast Track in the ER (4PM - 2AM 8 days a month for a total of 80 hrs a month) and will be working in a small rural ER in WY and MT 3 days a month. I am back to enjoying what I do having been major burned out for several years and just hanging on. Now I am happy and satisfied. No major work-ups, no nights. I ride my motorcycles, shoot my guns and travel whenever I want. Unfortunately, now my wife is working harder than I am. Retirement is great and I'm glad I made it.
Reply

Add comment

Security code
Refresh

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM