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:
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