TORONTO — More than one in 10 doctors working in Canada are aged 65 or older — and about a third of those continue to work full time, says a report by the Canadian Institute for Health Information.
The report, based on 2009 figures and released Thursday, found about 12 per cent of Canada’s roughly 68,000 doctors — or almost 7,900 — were at least 65, up from nine per cent five years earlier. Those in that age bracket who were no longer practising full time were still carrying a 40 per cent workload on average.
Unlike more traditional workers in the labour force, physicians often continue past the typical retirement age of 65, said Walter Feeney, a senior analyst for CIHI.
“Physicians aren’t going to reach age 65 and drop off the map. They’re not going to disappear from the workforce,” he said from Ottawa. “There are still quite a few physicians that continue working into their senior years.”
For some, that means changing their scope of practice, says the report entitled “Putting Away the Stethoscope for Good? Toward a New Perspective on Physician Retirement.”
For instance, older family doctors may no longer perform complex or delicate procedures like vasectomies or may give up time-consuming and labour-intensive obstetrics.
“Perhaps they’re complicated procedures,” said Feeney, “but they could be on call and the physician could … say, ’I’ve done that for years, I want to work more regular hours. I don’t want to be up at two in the morning running to the hospital to do these deliveries.”’
Dr. Dale Dauphinee said the report resonated with him because of his own experience and that of his medical school classmates.
At about age 55, he decided not to return to his specialty as a gastroenterologist at a Montreal hospital after a period in administrative leadership roles. The reason: he had developed arthritis in his hands and felt he could no longer perform colonoscopies and other endoscopic procedures requiring manual dexterity.
“It’s an example of where my life circumstances really led me to think it’s time to make a shift,” Dauphinee, 72, said Thursday from Montreal. So he turned to teaching medical students and consulting, instead.
At a recent reunion of his 1964 Dalhousie University graduating class, he found that classmates who had also become surgeons often had continued in the operating room until their late 60s or early 70s, “and then they just stopped.”
“I’ve seen some family doctors who are older who still practise. But they don’t do obstetrics anymore,” he said, adding that the report was “like looking at my class. So it rang very true to me.”
While the report doesn’t examine why many retirement-age doctors continue to go to their offices or hospitals, Feeney said there are a number of possible reasons, including that physicians usually begin their careers later in life than those in more traditional jobs, following years of medical training.
As well, physicians may tend to find their professional a calling, he added. “It’s not just a Monday-to-Friday, nine-to-five job. They find they need to provide the care for the public.”
Dr. Rob Boulay, president of the College of Family Physicians of Canada, agreed that the commitment to patients and the profession is a major driver that keeps doctors practising.
“It’s almost a way of life after a while,” Boulay said from Miramichi, N.B. “I think it’s very hard to not have the type of relationships that physicians develop all their lives with their patients.
“For a lot of people, it’s part of their identity as well. If your identity is being a physician and that’s how you’re recognized in your community, I think it might be hard to make a departure from that.”
Financial reasons are also behind many doctors hanging onto their white coats and stethoscopes after they join the ranks of senior citizens, he suggested. “I know that a downturn in the market changed a lot of physicians’ plans for retirement because we fund our own retirements, of course.”
Feeney suggested that because most doctors are self-employed, they also have the flexibility to keep working but to put in shorter hours or fewer days. “They can decide their own work-life balance.”
He said the report provides important information for governments and other bodies in planning for Canada’s future health provider needs.
While a large number of Canadians are unable to find a family doctor, the country’s physician workforce is actually on the rise: not only are some retirement-age doctors staying on the job, but medical school graduates are at a record high.
Boulay said new methods of delivering primary health care that supports family doctors is helping them to work longer and more productively.
Team-based practices involving many types of health provider can give family physicians who may have worked for years in solo practices a new lease on their work life, he said.
“I’ve heard anecdotally from physicians who’ve done that when they felt that they couldn’t work anymore, when they enter one of these practice models, they feel like they’ve been reborn. They feel like they can continue to work.”