By Brian Rosenfeld, MD
Physicians have a long-established pattern of working many years beyond when other professionals have on average retired. Before the pandemic, that trend was poised to continue with a survey showing widespread career satisfaction among all doctors, especially older physicians.
But COVID-19 has changed all that, marking a profound shift in physicians’ professional outlook. A year and a half into the pandemic, a December 2021 survey of thousands of physicians revealed widespread burnout, depression and fear of infection, especially among older docs. One in three respondents said they intended to reduce work hours in the next 12 months and one in five was likely to leave their current practice within two years.
The pandemic appears to have increased the American Association of Medical Colleges’ projection of a physician shortage of 37,800 to 124,000 physicians by 2034. Even if only a third of physicians followed through on their intention to join the Great Resignation, the American Medical Association says we would lose the ability to keep our health system functioning for an aging and growing patient population.
It is easy to sit back and lament what has occurred, especially as COVID subvariants show no sign of letting up. And yet, there is hope: We have moved into the era of digital health, which offers mid-career and older physicians the chance to continue practicing medicine without the stress of commutes, on-call hours, exposure to illness – and with the ability to reduce workload at their own pace, not their practice’s.
Telemedicine offers myriad full- or part-time roles. While this type of practice doesn’t lend itself to procedural interventions (surgery, diagnostics, and therapeutics), most physicians can now practice using their years of training, their vast experience, and a HIPAA-compliant computer. For instance, intensive care doctors, one of the specialties at the tip of the COVID spear, were previously bound to a bedside/office practice, but they can now provide their expertise to patients across the U.S. This opportunity to help care for patients across a wide geography, particularly to places that previously would never have attracted intensivists can be so gratifying. Sub-specialty consultations are also now readily enabled through audio-video interactions and access to the patient’s electronic medical record.
There are many advantages that telehealth brings to physicians who are close to retirement, are burned out in mid-life, or are looking to make a lifestyle change:
- You can work from home, wherever that happens to be, as long as it is within the U.S., and you have good broadband.
- Time with your family is the ultimate currency, whether it’s your significant other, young children/adolescents, or grandkids for the Baby Boomers. To use the old adage, nobody’s tombstone ever said, “I wish I had spent more time at the office.”
- You regain life control. You can work as many shifts as you want as long as you maintain a baseline number. Being able to provide your medical expertise for additional years addresses the issue of losing vitality by not being mentally engaged.
- You can maintain financial security while you ease down the road to retirement. This opportunity has never existed before. Remote care also provides opportunities for employment, with health benefits, a 401k and paid time off.
Last, but hardly least, is telehealth’s societal impact. Keeping older doctors on the job remotely would alleviate a significant part of the looming physician shortage, perhaps long enough for medical schools and residencies to increase the flow of new blood into medicine. And it extends specialist expertise to places that have never had it, such as rural hospitals.
So, my burned-out colleagues, look to what opportunities exist for you in the new digital world of medical practice before thinking about hanging up your white coat for good.
Brian Rosenfeld, MD, is a board member of Equum Medical and other companies. A former practicing intensivist and Associate Professor of Anesthesia, Medicine and Surgery at Johns Hopkins School of Medicine, he invented and commercialized the first continuous tele-ICU Program and cofounded VISICU, a publicly traded telehealth provider that was acquired by Philips Electronics.