• Lindsay Hedden, M Ruth Lavergne, Kimberlyn M McGrail, Michael R Law, Lucy Cheng, Megan A Ahuja, and Morris L Barer.
• Centre for Clinical Epidemiology and Evaluation (Hedden), Vancouver General Hospital, Vancouver, BC; Faculty of Health Sciences (Lavergne), Simon Fraser University, Burnaby, BC; Centre for Health Services and Policy Research (McGrail, Law, Cheng, Ahuja, Barer), University of British Columbia, Vancouver, BC lindsay.hedden@ubc.ca.
• CMAJ. 2017 Dec 11; 189 (49): E1517-E1523.

BackgroundKnowing when physicians retire and how they practise in the pre-retirement years is important information for health human resource planning. We identified patterns of retirement for physicians in British Columbia and the determinants of when and how physicians retire.MethodsFor this population-based retrospective cohort study, we used administrative data to examine activity levels and to identify retirements among BC's practising physicians. We included all physicians who were at least 50 years of age as of March 2006 and who had received payments for clinical services in at least 1 year between 2005/06 and 2011/12. We defined retirement as a permanent drop in monthly payments to less than $1667/month ($20 000/yr). We examined the patterns and timing of retirement by age, sex, specialty and location using linear and logistic regression models.ResultsOf the 4572 physicians who met the inclusion criteria, 1717 (37.6%) retired during the study period. The average age at retirement was 65.1 (standard deviation 7.8) years. Controlling for other demographic and practice characteristics, we found that women and physicians working in rural areas retired earlier, by 4.1 (95% confidence interval [CI] -4.9 to -3.2) years and 2.3 (95% CI -3.4 to -1.1) years, respectively. We found no difference in retirement age by specialty. We identified 4 patterns of pre-retirement activity: slow decline, rapid decline, maintenance and increasing activity. About 40% of physicians (440/1107) reduced their activity levels by at least 10% in the 3 years preceding retirement.InterpretationDuring the study period, physicians in BC - particularly women and those in rural areas - retired earlier than indicated by licensure and survey data. Many physicians reduced their practice activity in the pre-retirement years. These trends indicate that forecasts relying on licensure "head counts" are likely overestimating current and future physician supply.© 2017 Joule Inc. or its licensors.

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