Retraining Retired Physicians to Return to Primary Care, Part Time

Ever since retired reconstructive and plastic surgeon Leonard Glass launched a 100-hour program to help his retired specialist peers segue back into primary care on their own terms - without the hectic on-call and weekend schedules of their full-time peers - the response from physicians has been overwhelmingly positive.

The program, developed in collaboration with the University of California San Diego School of Medicine, entitled Physician Retraining & Reentry, launched Aug. 1, 2013.

Glass, a 78-year-old San Diego resident, said his program was developed in response to a growing demand for primary-care physicians and the expected influx of patients due to the Affordable Care Act. But a second benefit is that physicians will be able to re-enter the marketplace without worrying about financial (e.g., overhead) and other responsibilities that usually are par for the course.

"The benefits are you have no call on nights and weekends and you don't get exhausted from working every day and night and so on," said Glass. "I worked very hard for many decades, and many doctors do that."

Recent surveys of retired physicians, including an informal one Glass' organization conducted of 258 retired physicians in San Diego County, have supported the notion that "a very large percentage of doctors would be interested in returning to work as a physician if they had no financial responsibilities, and if they could practice on their terms, which could be one, two, or even three days per week," said Glass.

The online program costs $7,500 and can be completed in as few as three to four months (there are 15 courses, each of which assesses a particular aspect of general medicine).

Phil Miller, vice president of communication for Merritt Hawkins, agreed there are quite a few retired physicians who prefer temporary, or "locum tenens" assignments. According to a 2013 survey by Staff Care, a Merritt Hawkins affiliate that specializes in locum tenens staffing, 45 percent of physicians working locum tenens indicated they are 60 years old or older. Staff Care also estimates that about 38,000 physicians will work as locum tenens this year, up from 26,000 in 2002.

Yet while the idea for such a course is a promising one, it's not a new one, and there are some issues that may come up in a transition to primary care, said Miller.

"Back in the 1990s, when it was assumed that managed care/capitation would become the predominant delivery model, there was a lot of speculation that specialists would have to retrain as primary-care doctors, because there wouldn't be enough for specialists to do," said Miller. "That did not happen. One of the limiting factors of this program is that specialists and primary-care doctors often have differing skill sets and perspectives. Primary care is about listening, diagnosis, and care coordination, where specialty care often is about performing a test or procedure. The first focuses on a process, the other on a task. I am not sure that many specialists will be willing to cross over, but any that do would be helpful."

(Wondering why an increasing number of physicians are scaling back their hours to part time? Read: Going Part Time at Your Medical Practice.)

Marisa Torrieri is an associate editor at Physicians Practice. She can be reached at marisa.torrieri@ubm.com.

This article originally appeared in the January 2014 issue of Physicians Practice.