Physician Reentry into the Workforce

Ethan Alexander Jewett, MADivision of GME & Pediatric Workforce

American Academy of Pediatrics

Committee on Pediatric EducationNovember 18, 2007

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.

Why is this issue important?

Unmet patient need – underserved areas and anticipated public health crisis

Many physicians leave medicine for a period of time

Federal investment in GME – “Medicine is a public good.”

A mechanism to bring more flexibility into the system (e.g the attractiveness of medicine as a career)

Who are the stakeholders?

Federal/state governments

Regulatory groups (state licensing boards)

Federal agencies (Veteran’s Health Administration)

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

The Physician Reentry into

the Workforce Project

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.

What are our assumptions? (cont.)

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.

Reentry into the Workforce Project Workgroups

Assessment and Evaluation

Education

Licensure, Maintenance of Certification, and Credentialing

Workforce

Education Workgroup Activities

Learner’s Bill of Rights for physician reentry programming

Critical elements for physician reentry programming

Needs assessment

Education

Evaluation

Online clearinghouse of reentry programs/educational

offerings

Accreditation and standards for reentry programs

Joan F. Giambalvo Memorial Scholarship Fund - 2007 Award

Established by the AMA Women Physicians Congress to support health services research on professional issues related to women in medicine.

Ethan Alexander Jewett, MASenior Health Policy AnalystAmerican Academy of Pediatrics

Physician Reentry Into Clinical Practice

Research Proposal

This research project will query a random sample of physicians on several issues related to physician reentry. The sample will consist of 5000 physicians under 65 who are listed in the AMA Masterfile as clinically inactive. It will include physicians in all specialties.

It is hypothesized that many physicians wish to return to the workforce, but are prevented because of the absence of structured and affordable reentry training programs.

Structure of Survey

Physicians not currently active in medicine

Physicians currently active in medicine (includes clinical practice, research, teaching, and administration)

Physician demographics (i.e., age, gender, marital status, dependents, race/ethnicity, health status, financial status, USMG/IMG, education, specialty/subspecialty.

Reentry Survey Topics

Licensure and maintenance of board certificationLiability insuranceFinancial needFamily responsibilitiesProfessional satisfactionWork hours and professional responsibilitiesPart-time practiceRetraining modalities

What do we hope to learn?

Reasons for physician exit and reentryIncentives to encourage inactive physicians to return to medicineBarriers to inactive physicians returning to medicineDemographics 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

Partnership with the American Medical Association

Resolution 316 passed at House of Delegates (A-06)RESOLVED, That our American Medical Association, in collaboration with appropriate

state and specialty societies, the Accreditation Council on Graduate Medical Education,

and the American Board of Medical Specialties, study the issue of physician re-entry into

practice, after a leave of absence from practice, or a limitation of certain aspects of

practice, including a consideration of issues related to retraining, certification, and

credentialing (Directive to Take Action); and be it further

RESOLVED, That the proposed AMA study on physician re-entry into practice also assess

the overall impact of re-entry issues on the physician workforce. (Directive to Take Action)

Partnership with the American Medical Association (cont.)

Guiding Principles for AMA Council on Medical Education

Report (in response to Resolution 316)

Survey on Physician Reentry into the Workforce

AMA-AAP Joint Conference on Physician Reentry into the

Workforce (projected for fall 2008) – topic likely to be on

overcoming barriers to licensing, credentialing and

maintenance of certification.

http://www.aap.org/reentry