John Gommans
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John Gommans is a dual trained Physician achieving his FRACP in General Medicine and completing post-fellowship training in Geriatric Medicine. He has worked for over 25 years as a General Physician and Geriatrician at Hawke's Bay Hospital with a special interest in stroke medicine, guidelines and research. He is also the hospital's Chief Medical Officer. He is a Past-President of IMSANZ and Past-Chair of the New Zealand Adult Medicine Division Committee of the RACP.
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Aging Physicians And The Retirement Transition
All Physicians experience a number of transitions throughout their career; from student to doctor, trainee to junior consultant, mid-career changes in practice and to partial or full retirement.
The RACP 2017 NZ election statement with ‘make good work the norm’ as one of its three key messages reminds us of the importance of meaningful work to individuals and society; it also reminds us that this is not restricted to paid employment.
Aging may be associated with physical or mental changes that directly affect a Physician’s work and knowing when to give up practice is an important decision for most doctors and a critically difficult decision for some. However, there is no age cut off or clear guidance to help decide what level of cognitive impairment may put the public at risk.
For the willing physician, RACP workshops have identified factors that make the retirement transition successful including support from family, having something to retire to, maintaining interests outside medicine and planning well in advance. However, only 50% of Physicians actively plan. Planning may include reduced shift and on call work, considering part-time or reduced hours and changing to less stressful (and risky) roles e.g. less procedural work, less demanding leadership roles, changes in case mix, more outpatient duties and longer clinic times. All of these strategies require the support of employers and colleagues.
Challenges for the aging but less willing Physician include loss of self-esteem, inadequate retirement income, lack of meaningful activities or interests outside work and for many a self-belief in their competence and ability but with little or no objective assessment of this. Options that may assist the wider profession and colleagues include; supporting reduction in workloads and stress, advice from a mentor or trusted colleague, formal peer review, 360 degree feedback and regular Professional Development Reviews. If there are genuine concerns regarding performance then a formal performance review and management processes, and Occupational Health and cognitive testing may be required.
The RACP 2017 NZ election statement with ‘make good work the norm’ as one of its three key messages reminds us of the importance of meaningful work to individuals and society; it also reminds us that this is not restricted to paid employment.
Aging may be associated with physical or mental changes that directly affect a Physician’s work and knowing when to give up practice is an important decision for most doctors and a critically difficult decision for some. However, there is no age cut off or clear guidance to help decide what level of cognitive impairment may put the public at risk.
For the willing physician, RACP workshops have identified factors that make the retirement transition successful including support from family, having something to retire to, maintaining interests outside medicine and planning well in advance. However, only 50% of Physicians actively plan. Planning may include reduced shift and on call work, considering part-time or reduced hours and changing to less stressful (and risky) roles e.g. less procedural work, less demanding leadership roles, changes in case mix, more outpatient duties and longer clinic times. All of these strategies require the support of employers and colleagues.
Challenges for the aging but less willing Physician include loss of self-esteem, inadequate retirement income, lack of meaningful activities or interests outside work and for many a self-belief in their competence and ability but with little or no objective assessment of this. Options that may assist the wider profession and colleagues include; supporting reduction in workloads and stress, advice from a mentor or trusted colleague, formal peer review, 360 degree feedback and regular Professional Development Reviews. If there are genuine concerns regarding performance then a formal performance review and management processes, and Occupational Health and cognitive testing may be required.
