Physicians Vary on Retirement Plans

Editor's note: We work hard to write about issues that will help physicians run their practices in a manner that is both prosperous and efficient, while still delivering quality patient care. And we are delighted when our readers let us know what they are thinking. This month we are excerpting an article on documenting in the EHR while focusing on the patient as well as survey results that found physicians are hesitant to retire. The articles have been edited for space and are followed by comments made by readers at PhysiciansPractice.com.

Documenting in the EHR and Focusing on the Patient

Mott Blair, a Wallace, N.C.-based family physician, doesn't get distracted by the EHR in the patient exam room. That's because he keeps it in the hallway, right outside the exam room. He uses an old-fashioned clipboard and paper to take notes during patient visits. "I do all my work face-to-face with patients. I maintain that eye contact, and I always listen," he says.

Polly says: You could remove the word physician in this article and replace it with any other healthcare provider. The computer is not the most important person in the room. Whether the caregiver is a nurse, coordinator, dietician, scheduler...we all need to keep the focus on the patient and remember that the technology is only a tool. Well done, Dr. Blair!

Erik says: Then get rid of the EHR so we can focus on patients again. It's only there to help accountants, administrators, business folks, and lawyers collect data to make millions off of the work of the physician. A hand written note tells me every relevant thing I need to know.

William replies: Finally some common sense!

Boutros says: I do not take the laptop in the room. I look at the problem seven med list, then go sit by the patient's side. I have 5000 clients and this works great for me.

Ramin says: I appreciate the provider's attention to the patient. This is important. However, [there are] many ways to get this done. We use scribes at our practice. The physician is technology free and directly focused on the patient….The scribes should have a pretty polished first draft prepared for the provider. Dictation is another option. Having providers input all the data into the medical records is simply a poor use of their time which is a loss for both the patient and the practice.

Physicians Hesitant to Retire, Study Finds

Late-career physicians are hesitant to retire due to fear of missing the field they love, a new study from CompHealth finds. The study also revealed older physicians say they would miss the social dynamic that comes with their work environment. CompHealth surveyed more than 400 late-career physicians, age 50 and up in specialties including psychiatry, emergency medicine, OB/GYN, surgery, and primary-care, to conduct the study.

Kent says: I have delayed "retirement" for most of the reasons your study indicate - social interaction of the workplace and also the altruistic and feeling of being "needed" where healthcare is needed the most, in the emergency room. I have practiced emergency medicine since 1970 (47 years), am board certified in three specialties (IM, Rheumatology, EM), and would not want to retire after so much time and effort achieving those goals. I realize there may be other opportunities (volunteering, teaching, etc.) but it does not give the same personal satisfaction. Depending on health and mental condition, I feel I can contribute for a few more years.

Thomas replies: WOW!! I started practicing Emergency Medicine in 1976, right after my residency in Family Medicine, because that was the field of medicine I found most challenging, and, as you know, since there only a handful of really good residency programs in EM back in the early '70s. I felt like I was a real pioneer in this wonderful field, but your career is truly representative of what the term "Founding Father" is all about…Congratulations on an amazing career!!

Bill says: While I love my job, I find the ever increasing regulations/requirements outweighing a long career as a solo practitioner. Early retirement seems to be the best way out of burnout...

Mark replies: I completely agree. I am turning 40 on Sunday and if I could financially retire today, I would. This bureaucracy of paperwork, computer work, MIPS/MACRA, etc. has ruined medicine. I no longer enjoy it and would not do it again. I encourage every young person to stay out of medicine. I can still help people but it comes at too high a personal cost. I have to see 30 [patients] per day and I am always sick and tired. I don't make enough money to justify this work life. My home life is terrible since I don't have the time and energy to enjoy my beautiful wife and three wonderful children. Not many positives right now.