Michelle Pannor Silver1*, Angela D Hamilton2, Aviroop Biswas3 and Sarah A Williams4
1University of Toronto Institute of Health Policy, Management and Evaluation, and the University of Toronto Scarborough Campus, Canada
2University of Toronto Scarborough Campus, Canada
3University of Toronto Institute of Health Policy, Management and Evaluation, Canada
4University of Toronto Department of Anthropology, Canada
Received: 23 November, 2015; Accepted: 22 December, 2015; Published: 02 January, 2016
Michelle Pannor Silver, 1265 Military Trail Toronto, Ontario Canada, M1C1A4, Tel: 416-287-5642; Fax: 416-287-7283; E-mail:
Silver MP, Hamilton AD, Biswas A, Williams SA (2016) Life after Medicine: A Systematic Review of Studies of Physicians’ Adjustment to Retirement. Arch Community Med Public Health 2(1): 001-007. DOI: 10.17352/2455-5479.000006
© 2016 Silver MP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: A physician’s decision to retire has personal and social consequences. While there has been growing interest in how individuals adjust to retirement, less is known about physicians’ adjustment to retirement.
Objectives: To identify and examine: 1) factors that influence how well physicians adjust to retirement; 2) reasons physicians give for retiring; and 3) advice physicians give for a successful adjustment to retirement.
Methods: A systematic review of the literature was performed by searching Medline, Web of Science, Scopus, CINAHL, Ageline, Embase, Health star, ASSA, and PsycINFO databases for peer-reviewed studies published with quantitative and/or qualitative analyses of physicians’ adjustment to, satisfaction with, and/or quality of life in retirement. Two independent reviewers performed data abstraction, a quality assessment and an additional reviewer resolved inconsistencies. Content analysis was used to identify and stratify information from selected studies into themes and subthemes.
Results: Based on analyses of 12 articles that met the eligibility criteria, it is evident that retirement from medicine was seen as a generally favorable phenomenon. Financial security, favorable health, engagement in activities, and psychosocial well-being were identified as key factors relevant to physician retirement adjustment. Findings suggest that physicians’ retirement transitions could be eased by a greater focus on financial planning, implementation of strategies to encourage the development of outside interests, and institutional retirement planning that honors the physician and takes place mid-career or well in advance of retirement.
Conclusions: Advance planning to ensure that physicians have a strong financial situation, good health, engagement in activities outside of medicine, and positive psychosocial dynamics are likely to enhance adjustment to retirement for physicians. Future studies should account for multiple interrelating factors such as gender, changes over time, and spousal retirement to further enhance our understanding of physicians’ adjustment to retirement.
Interest in the factors that promote adjustment to life after work has become an increasingly relevant and critical topic of study [1,2], particularly because transitioning to retirement can be associated with depression and other challenges [3-5]. An increase in the number of physicians facing critical retirement decisions has been projected as North American physicians enter traditional retirement age [6,7]. However, less is known about what constitutes successful adjustment to retirement for physicians and how a positive transition might be facilitated.
Health care has undergone rapid changes in the last several decades while models of training and practice have not kept up, resulting in great stressors for practicing physicians [8,9]. Concerns about the aging physician population have largely centered on early attrition , burnout , the high costs associated with replacing retired physicians , and fears about shortages in the supply of physicians relative to the demands of a growing aging population [11,12]. Other evidence suggests that physicians may be reluctant to retire due to fears of losing their personal identity and life purpose [13-16]. Understanding the needs of physicians and factors that support their successful adjustment to late career transitions is a critical area for study.
For many older workers, retirement comes as a welcome respite at the end of a lifetime of toil, while for others it is a fearful time of unknowns where one’s identity and standing in the world are called into question and eventually re-made into something new and not necessarily welcomed. As increasing life expectancies extend the amount of time people spend in retirement to as many as three or four decades, retirement itself becomes a life stage with considerable importance and opportunity for growth and personal development. Medicine is an all-consuming and demanding profession. Physicians enter into medicine after lengthy training and are required to treat individuals at their most vulnerable state. After decades of practice and dedication to patients, physicians may have spent little time thinking about or planning for retirement. Toward the later part of their life-course, physicians may also become vulnerable and knowledge about how to enhance their adjustment to retirement can be helpful for both encouraging the hesitant physician to retire and for ensuring that the transition to retirement is made in a way that maximizes the chances of a smoother transition.
This systemic review examined the current state of what is known about physicians’ adjustment to retirement and identifies potential gaps in this literature by addressing three research questions: 1) what factors influence how well physicians adjust to retirement?; 2) what reasons do physicians give for retiring?; and 3) what advice do physicians give for a successful adjustment to retirement?
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting and production of this systematic review . The PRISMA checklist is included as Additional File 1. Published articles were searched using Medline, Web of Science, Scopus, CINAHL, Ageline, Embase, Healthstar, ASSIA, and PsychINFO databases. Each author participated in the identification and final selection of studies.
Our inclusion criteria were published peer-reviewed studies with quantitative and/or qualitative analyses of physicians’ adjustment to, satisfaction with, quality of life in, and/or opinions about retirement. Keywords in our search strategy included, ‘physician’ and ‘retire’ with appropriate synonyms. The full search strategy appears as Additional File 2. After discussion, the search strategy was narrowed to English-language articles up to November 2015 with no limit set for the earliest possible date of publication. We also conducted hand searching of citation lists for eligible studies and relevant review articles. We excluded a substantial portion of articles that appeared in our initial search on the basis of their being duplicate records, editorials, commentaries, articles that were not based on original data collection, articles grouping physicians with other healthcare professionals, or studies that focused on retirement planning among non-retired physicians (Figure 1).
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