How physicians can develop a practical retirement plan

June 1, 2008

Baby boomer urologists are reaching retirement age. This issue raises a number of questions and practical concerns about retirement, especially in group practices.

Key Points

These and other questions about retirement are often ignored or poorly understood until the event is imminent, and some of the issues require thoughtful planning. For this article, we interviewed Gary Kirsh, MD, immediate past president of the American Association of Clinical Urologists and chairman of the board of the Urology Group, a 35-member single-specialty group in Cincinnati.

Beyond what is required and what is reasonable, lies what is professional and courteous. Consider sending a letter to your patients well ahead of your retirement date and, if possible, before their next appointment with you. This will give them ample time to consider their own alternatives and prepare for their goodbyes to you. The letter should specifically define the process for transfer of their medical records, if necessary. If you are expecting your patients to stay within the practice, consider a schedule and workflow that will allow you to personally introduce them to their new urologist. Patients who are comfortable with an older physician may be anxious about seeing a younger urologist or one of a different gender.

By seeing the patient together, the retiring physician can reassure the patient that he is in the hands of a capable colleague who can provide the same quality of care he has come to expect. A summary note in the chart or electronic record will be appreciated by the receiving physician, and can help make that first visit seem like continuous care to the patient.

Check with your state board or licensing agency for a list of requirements that must be met when a physician leaves or retires. Some states (Texas is one) require the same legal notices and notice be provided to the public and patients whether the physician is moving offices within the same group practice, relocating the practice out of the area, or simply retiring and leaving the charts with the same group practice where he/she worked.

Group considerations

Group practices have additional considerations when a partner retires. First, what constitutes retirement? It is natural for physicians to change the nature of their practices toward the ends of their careers-perhaps performing little or no major surgery, seeing fewer patients in a day, not accepting new patients, not taking call, etc. At what point does a physician go from full time to part time, or to retirement?

Passive income from ancillary ventures can be a disincentive to retire, according to Dr. Kirsh. This can be a source of friction in a practice with multiple generations of physicians and an obstacle to growth of the group, and should be addressed in the partnership agreement. Some practices consider a mandatory retirement age. This can be helpful to prevent uncomfortable discussions about a partner's ability to perform surgery or other tasks, but, according to Dr. Kirsh, may constitute discrimination if applied too broadly.