Physician Reentry into the Workforce

1. Physician Reentry into the Workforce Holly J. Mulvey, MA Ethan Alexander Jewett, MA Co-Directors

2. Definition Physician reentry into the workforce can be defined as returning to professional activity/clinical practice for which one has been trained, certified or licensed after an extended time period.

3. Who are the stakeholders? Federal/state governments Regulatory groups (state licensing boards) Federal agencies Hospitals (including The Joint Commission) Medical/specialty societies Specialty boards Organizations invested in physician workforce planning Groups with an agenda that focuses on women in medicine Individual physicians

4. Some reasons for leaving the workforce Health Substance abuse Retirement Burnout Loss of licensure Family needs (children, elderly parents) Career change (eg, administrative position, research)

5. Some reasons for reentering the workforce Financial reasons Responding to a need in the community (ie, natural disaster) To pursue a new challenge or area of medicine Miss colleagues and/or practice environment Miss caring for patients Too much free time on my hands

6. Why is this issue important? Many physicians leave clinical medicine for a period of time Federal investment in GME � �Medicine is a public good.� Unmet patient need � underserved areas and anticipated public health crisis A mechanism to bring more flexibility into the system (eg, the attractiveness of medicine as a career)

7. Some questions to consider Is the structure of the health care system too rigid to accommodate diverse practice/career/personal needs? Do MDs need to �leave� because the system won�t give? Will we face an unstable MD workforce?

8. AAP participation in the AAMCSurvey of Physicians Over 50 Collaboration of AAMC, AAP, and 8 medical associations AAP used existing Periodic Survey of Fellows survey instrument 1158/1600 surveyed (72% response rate) Women=26%; Men=74%

9. Work/practice opportunities

10. Reduced hours/part-time

11. Extended leave from medicine

12. Reasons for extended leave

13. Retraining before reentry

14. Reasons for reentry

15. Physician Reentry into the Workforce Project

16. What are our assumptions? Physicians returning to the workforce will face questions about their competence to resume clinical practice. The educational needs of physicians who wish to return to clinical practice are extremely diverse. With the growing proportion of women in pediatrics and other specialties, there will likely be an increase in the number of pediatricians taking an extended leave during their career or returning to medicine after retiring. Physicians who choose to leave the workforce for a period of time risk losing their state licensure, their Board certification and hospital privileges.

17. Assessment and Evaluation This workgroup will need to identify appropriate methods for evaluating an individual physician�s competence and need for retraining. Once a physician has undergone retraining, a valid assessment will need to be in place to assure the public that the physician is skilled and competent to resume the practice of medicine.

18. Education

19. Licensure, Maintenance of Certification, and Credentialing

20. Workforce

21. Works-in-progress: Workforce survey Random sample of 5000 physicians under 65 listed as inactive in the AMA Masterfile. 3 mailings, 1/4/08, 2/1/08, 3/11/08 1,515 valid surveys, 584 bad addresses 2,868 nonrespondents 34.6% response rate, as of 3/28/08 Data presented at June 2008 AMA-HOD Annual Meeting (Women Physicians Congress)

22. Reentry survey topics Licensure and maintenance of board certification Liability insurance Financial need Family responsibilities Professional satisfaction Work hours and professional responsibilities Part-time practice Retraining modalities

23. What do we hope to learn? Reasons for physician exit and reentry Incentives to encourage inactive physicians to return to medicine Barriers to inactive physicians returning to medicine Demographics of inactive physicians Specialties most affected by physician exit and/or reentry Retraining/educational needs of reentering physicians Availability of opportunities and portals to reenter medicine

24. Works-in-Progress:Reentry Web page redesign Redesign in March 2008 to mark transition from planning to implementation Expansion of resources related to the work of the Project and its workgroups (internal) Addition of resources for physicians seeking to reenter the workforce (external) Showcase research initiatives

26. Other reentry products in development Journal article on reentry data on pediatricians from joint AAP-AAMC Survey of Physicians over 50 Proposed joint AMA-AAP conference in fall 2008 on physician reentry issues Abstracts and manuscript on reentry survey data planned for 2009

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28. Contact the Division of Workforce & Medical Education Policy Holly J. Mulvey, MA Director Division of Workforce and Medical Education Policy American Academy of Pediatrics 141 Northwest Point Blvd. Elk Grove Village, IL 60007 hmulvey@aap.org 847.434.7915 847.434.8000 (fax) Ethan Alexander Jewett, MA Senior Health Policy Analyst Division of Workforce and Medical Education Policy American Academy of Pediatrics 141 Northwest Point Blvd. Elk Grove Village, IL 60007 ejewett@aap.org 847.434.7914 847.434.8000 (fax)