The Need For Family Doctors To Retire Responsibly

By Sonia Bianchi and Tessa MacDougall

Dr. Jean Clarke and her family practice partner were about to retire from over 30 years of practice when the uncertainty of their 2,500 patients’ futures along with Dr. Clarke’s own hit her. Her patients, many of whom she’d fostered relationships with for decades, were faced with the possibility of losing their connection to a family doctor.

“It dawned on me what a significant transition this was not only for me but also all these people who had placed their trust in me – some of them for many years,” says Dr. Clarke, who has not only cared for her patients but their children as well. “We’ve followed a lot of our patients through their life journey. It can be frightening to lose that. My clinical partner and I decided to retire at the same time but we realized that we weren’t entirely sure how best to go about it and in a way that would have a minimal impact on our patients.”

Dr. Clarke and her partner are certainly not alone in facing this situation. The rapid rate of retirement for baby boomer-aged doctors is a looming issue in our healthcare system. Canadians are increasingly feeling the effects of more and more doctors retiring. This disruption adds strain to the healthcare system, creating anxiety for both GPs and patients.

In Canada, retiring doctors and their patients are creating a number of problems. When a physician ends their practice it creates a period of uncertainty for patients who have not found new GPs but are still in need of continuous care. Patients without a family doctor cost the system more in the long run when they receive episodic care from multiple short-term provider solutions. It has been proven that an ongoing physician/patient relationship benefits the system, reduces costs and provides better preventative and long-term care.

In British Columbia, a number of partners are working to address the concern of GP retirement as well as access and capacity within the system. In particular, the Vancouver Division of Family Practice plays a fundamental role in providing retirement guidance to family doctors in the region. The Vancouver Division works with doctors to ensure they retire effectively and responsibly while recruiting new doctors, retaining and engaging existing doctors, and attaching high priority patients to ensure continuous care.

The Vancouver Division has started a number of initiatives to address the retirement and physician access issue. In addition to counselling and events, a recently launched How-to-Retire Guide outlines a retirement support program that takes family doctors through the process of responsible retirement with tips around creating a plan, developing a cost framework, identifying gaps and recruiting replacement physicians. This guide will be crucial for a seamless transition from retiring doctors to practicing doctors.

Dr. Clarke was one of the first doctors to try the Vancouver Division of Family Practice’s new retiring doctor support program. The Division provided advice around planning for their office closure and also supported the transition of Dr. Clarke’s patients to four different GPs. As a result of this support, Dr. Clarke and her clinic partner were able to inform their patients several months in advance of closing their offices with the good news that there was a new physician able to take on their care. Like many others, Dr. Clarke wanted to ensure that her patients were passed on to good hands.

“We’ve been able to retire with the peace of mind that all our Vancouver patients were connected with a new family doctor in our community and that made a big difference,” adds Clarke.

The Vancouver Division of Family Practice is continuing its work to address the doctor shortage. So far, it has successfully reallocated over 8,000 patients from retiring GPs while recruiting new doctors. Through the development of its Patient Matching Mechanism, it has matched over two thousand patients with complex needs to a family doctor and their clinic optimization initiative has made access to their physicians easier for attached patients.

“There’s a lot of anxiety and pressure on physicians to stay on because there is no capacity for accepting patients,” says Rose Gidzinski, the overall Division of Family Practice’s A GP for Me Project Implementation Manager. “We want to change the culture around retirement.”

“Ideally, GPs should give themselves a “longer runway,” before retiring so there’s plenty of time to plan, advise patients, and possibly find replacement doctors,” adds Gidzinski.

By identifying members slated to retire within the next six months to two years, the Division team can begin succession planning, including finding replacement GPs.

Transitions start with patients who are high needs with complex health issues, and who without continuous physician support, often end up in hospital. The remaining patients are then attached to the new physician accordingly. The Vancouver Division works to also support new physicians starting to build their practice who have the capacity to take on new patients, as well as facilitate the process for retiring physicians so patients do not fall through the cracks.

As for Dr. Clarke, once she and her partner had wrapped up their responsibilities to ensure that both their patients and themselves were confident they had retired appropriately, they decided to throw a tea party. They wanted to thank their patients for the privilege of knowing and caring for them over so many years, allowing them a wonderfully satisfying career. Many of their patients showed up to thank the physicians for the care they provided for over 30 years and for ensuring that, even upon retirement, they still had their best interests in mind.

Authors: Vancouver Division of Family Practice Retirement Support Team, Sonia Bianchi (Recruitment & Retention Manager) and Tessa MacDougall (Business Analyst)

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