Retrain retired doctors to avert future physician shortage

Regarding "Physician work force estimates far apart" (Article, June 20): Recent projections of physician manpower needs suggest that a severe undersupply of physicians again will occur, with a shortage of 51,000 to 228,000 physicians by 2020.

Predictably, there are those who advocate increasing medical school class sizes to ameliorate this shortage. But there exists another, less expensive way to help make medical care more available to our growing population of seniors.

By 2020, there will be a large cadre of retired physicians whose skills could be directed toward caring for an aging populace instead of being focused on improving one's golf game or bridge skills. Just as it is generally less expensive to remodel a home, rather than to build an entirely new dwelling, it would be less expensive to retrain those physicians willing to change career focus and work part time than it will be to select and train a greater number of matriculates to medical schools.

In other words, it is time to consider ways to permit redeployment of older physicians to serve our nation's health needs. There will be surgeons who are unable to operate due to physical infirmity, but who would be best suited to patient care rather than an administrative role. There will be emergency physicians who cannot handle night duty but whose medical skills could make them a great team member in an office setting, such as working with disease management teams caring for diabetic or congestive heart failure patients.

These physicians, and our society, would benefit if brief -- three to six months -- retraining programs existed to update and sharpen experienced physicians' skills, culminating in certification in a defined body of knowledge, so they could be redeployed in less physically taxing settings than they had left. Redeployment could occur using the semiretired older doctor as a team member with a fully boarded specialist. (Unfortunately, the only way for a physician to retrain at present, if he or she hopes to obtain any sort of specialty certification, is to complete an entire residency. This is an option that physicians in their 60s would only rarely, if ever, choose.)

If we, as a society, are serious about finding cost-effective means to ameliorate this physician shortage, we must explore options that do not now exist. A redeployed older physician, briefly retrained in a supervised setting in what would constitute a "mini-residency," would be a logical and attractive means for a partial solution of the upcoming manpower shortage. Our society should remodel its physician supply to augment the efforts of the new cadre of physicians who will be needed.

Gary Gaddis, MD, PhD, Shawnee, Kan.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/07/18/edlt0718.htm.