5 questions every older physician should ask themselves

A 62-year-old client said she planned to practice medicine 10 more years. This probably isn’t realistic. Often, saying 5 or 10 more years is an easy and round-numbered way of thinking about the future. I hear it a lot. But the aging process affects mental acuity and physical stamina. Practicing into your 70s may not be in the cards.

In addition, testing older physicians for mental and physical ability is growing more common. Experts at the AMA have suggested older physicians be screened to ensure they don’t pose a risk to patients.
I encourage clients to think realistically about how long they plan to practice. It’s a very personal decision and not one to make hastily. Although it is the end of their professional livelihood, which for many is much more than just a job, it’s the beginning of a brand new chapter that can be just as fulfilling - or even more so.

For older physicians who perform surgery or have a procedure-based practice, this is an issue of patient safety. Unfortunately, the culture of medicine has created an environment in which it’s difficult for your partners or hospital peers to be straight with you about the fact that your surgical health skills aren’t as sharp as they once were or your diagnostic abilities have slowed. But both of these can put patients at risk.

Primary care physicians might consider scaling back patient volume and developing a concierge-style practice. They might also consider leveraging technology and delivering a more limited number of services using telemedicine and house calls.

Solo physicians who may have difficulty finding a partner or a buyer could consider joining a larger group or seeking hospital employment in their next chapter.
Or, in a group setting, we’ve seen many senior physicians transition successfully into consulting physicians who perform new patient consultations or follow up. This peer-team approach to delivering care can increase collegiality and ease the appointment schedule.

The self-aware physician will usually answer no - and rightly so. If you are used to practicing solo, adding a physician can be difficult. I have seen this situation blow up more than once. Dr. Senior decides (or his spouse insists) to start slowing down, and he needs someone to share call. He brings on a young physician but is reticent to share practice finances, support the new doctor in practice building or assign a sufficient amount of staff. Before advertising for a new colleague, think carefully about whether it’s the right decision.

Receivables are a practice’s lifeblood. With deductibles rising and reimbursement rules changing, more and more practice receivables in need of resuscitation. The state of the A/R is particularly important if you are considering a practice transition. Any smart buyer or potential partner will want to see how you manage billing and collections. If you have more than 20% of receivables past 90 days and aren’t collecting patient responsibility amounts during the visit or prior to a procedure, your A/R systems need attention.