A research done by Flinders University, the University of New South Wales and the University of Sydney in Australia has found that older doctors are not retiring at the same ages they used to and are instead choosing to work far past their typical retirement ages.

Dr Chanaka Wijeratne, from the UNSW School of Psychiatry and colleagues recently surveyed 1,048 Australian doctors aged 55 and over to better understand the professional and psychosocial factors influencing their retirement decisions.

Cognitive stimulation an important factor

The online questionnaire was sent to 6,000 practising Australian doctors above the age of 55 and 1,048 responses were considered valid. 38% of the respondents said that they had no plans or were unsure about retirement. The other 62% had plans to retire but only two-thirds nominated an age, and about half of this group were already older than 65.

The reasons for not retiring vary. Out of the 398 doctors who were not considering retirement, a high number (87.7%) strongly agreed or agreed that the cognitive stimulation of being a doctor was an important factor. Other strong factors were a sense of purpose or goals (80.9%), being in good physical health (78.4%) and maintaining fulfilling professional relationships (63.8%).

As for the 650 doctors who intended to retire, there is also a range of reasons. 67.4% says the contributing factor is the desire to have more personal leisure time. Other factors for intending retirement include having financial security (57.1%), impaired by physical illness or disability (56%) and also cognitive impairment (54.5%). Among those with plans to retire, the median anticipated age was 70 for men and 68 for women, which is later than the rest of the community.

Not retiring due to financial reasons

Royal Australian College of General Practitioners president Dr Bastian Seidel said that older doctors are not retiring because of financial reasons, with the Global Financial Crisis causing a significant drop in retirement savings.

"The average GP income is now AUD130,000 (female), AUD180,000 (male), which is less than half of what a hospital doctor would earn. So to make up for the funding shortfall, GPs work longer," said Seidel.

Professor Brian Draper from the UNSW School of Psychiatry, who studies mental health problems and cognitive decline in old age, argues that doctors need to plan for retirement earlier in their careers as financial insecurity is one key factor keeping them in the workforce in late life.

Changing perceptions of retirement

But there are other factors, too.

"Sometimes they don't have enough money, and sometimes they have nothing else to go to in life," he says. "A medical career can't be the be-all and end-all. Doctors need to have a rounded life with other interests, and they need to nurture relationships outside of work."

Older doctors have valuable skills and experience and can be put in roles such as teachers, mentors and leaders. This is to factor in the declines in their cognition and patient outcomes; factors that are associated with ageing.

"There is a need for the profession to promote retirement as a final transition in a medical career, and provide resources for doctors to do so," stressed Dr Wijeratne.

As for the newly-minted doctors and the younger generation doctors, they are leaving the workforce by the droves. The expectation has been set high, entailing high levels of stress, causing some to not even make it out of housemanship.

A recent MIMS survey noted that 43% of healthcare professionals in Singapore and Malaysia are dissatisfied with the working hours. Long working hours in stressful conditions result in burnout, and is the common factor for the junior doctors not surpassing their seniors. When plagued with the high demands of work, young doctors do not feel like it is a fair trade off, finding little meaning in the vocation and choose to leave. MIMS

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