Recently the MJA published a letter from ASADA president, Dr Geoff Hawson, in response to an article on encore careers for doctors.
To the Editor: I commend Wijeratne and Earl1 for drawing attention to the retirement issues faced by doctors. Psychological issues are compounded by the lack of legislative provision for doctors to progressively step down from the demands of full registration. Reducing workload is not a simple matter. The impediments to maintaining registration while reducing workload include recency of practice requirements and up to 73 hours per annum of continuing professional development (CPD) for physicians2 —far exceeding that of other health practitioners.
Encore careers as described by the authors, while rewarding, could cause issues with the scope of practice requirements. Current guidelines around the definition of “practice of medicine”,3 unless changed, could find doctors practising medicine without a licence. Eighty-eight per cent of doctors in a local medical association survey (131 respondents; response rate 27%) supported a step-down approach, with 59% (of 113 respondents) supporting reduced CPD requirements.4
Many doctors see their profession as a calling and retain a strong desire to serve their communities both before and after retirement. Dignity and respect are key to effective transitions to retirement. Doctors often leave the profession on a sour note because their attempts to maintain registration in order to give back to their communities flounder under current regulations. There is despondency around the lack of recognition of their significant expertise and lack of regulator foresight in how to use the vast resource of senior doctors (eg, pandemics, fires, floods, community health needs). Australia appears to lag behind other countries in this regard. In the United States, states such as Pennsylvania offer retiring and retired doctors volunteer licences through their medical boards to volunteer their services for community health programs.5
The Australian Senior Active Doctors Association and the Australian Medical Association Queensland Senior Doctor Craft Group are working to achieve a step-down approach.6 Other professions recognise and encourage the active participation of retired members; for example, retired lawyers in several states, including Queensland,7,8 can apply for free practising certificates to undertake pro bono work. In many cultures, “senior” is synonymous with wisdom, leadership and excellence. While retirement planning is important, so is addressing practices and regulations that undermine and limit the value that senior doctors can bring to their communities as they transition through the latter stages of their careers.
1 Wijeratne C, Earl J. A guide for medical practitioners transitioning to an encore career or retirement. Med J Aust 2021; 214: 12–14. https://www.mja.com.au/journ al/2021/214/1/guide -medical-practitioners-transitioning-encore-career-or-retirement
2 Royal Australasian College of Physicians. 2021 MyCPD Framework. https://www.racp.edu.au/docs/default-source/fellows/cpd/2021-mycpd-framework.pdf?sfvrsn=a11f8 1a_6 (viewed Dec2021).
3 Australian Health Practitioner Regulation Agency. Ahpra glossary. https://www.ahpra.gov.au/Support/Glossary.aspx (viewed Dec 2021).
4 Hawson G. Attitudes to retirement and registration: survey results. RDMA Newsletter 2018; February. http://www.rdma.org.au/RDMA_Newsl etter_FEB_2018.pdf (viewed Dec2021).
5 Pennsylvania Medical Society. Volunteer licenses:what physicians should know. https://www.pamed soc.org/list/artic les/volunteer-medical-license-pennsylvania (viewed Dec 2021).
6 Australian Medical Association Queensland. Health vision. Part 2: workforce and training. https://qld.ama.com.au/sites/default/files/ QLD/PDFs/AMA%20Queensland%20Health%20Vision%20Part%202.pdf (viewed Dec 2021).
7 National Pro Bono Resource Centre. Engaging retired and career-break lawyers in pro bono; February 2010. https://probonocentre.org.au/wp-content/uploads/2015/09/Retired-and-career-break-lawyers-project-electronic-version_.pdf (viewed Dec 2021).
8 Queensland Law Society. Practising certificates. https://www.qls.com.au/Practising -law-in-Qld/Regulation/Practising -Certificates (viewed Dec 2021).