I hadn’t expected the tears.
My primary care doctor and I were saying goodbye after nearly 30 years together.
“You are a kind and a good person,” he told me after the physical exam, as we wished each other good luck and good health.
“I trust you completely — and always have,” I told him, my eyes overflowing.
“That means so much to me,” he responded, bowing his head.
Will I ever have another relationship like the one with this physician, who took time to ask me how I was doing each time he saw me? Who knew me from my first months as a young mother, when my thyroid went haywire, and who since oversaw all my medical concerns, both large and small?
It feels like an essential lifeline is being severed. I’ll miss him dearly.
This isn’t my story alone; many people in their 50s, 60s and 70s are similarly undergoing this kind of wrenching transition. A decade from now, at least 40% of the physician workforce will be 65 or older, according to data from the Association of American Medical Colleges. If significant numbers of doctors retire, as expected, physician shortages will swell. Earlier this year the AAMC projected an unmet need of up to 55,200 primary care physicians and 86,700 specialists by 2033, amid the rapid growth of the senior population.
Stress from the COVID-19 pandemic has made the outlook even worse, at least in the near term. When the Physicians Foundation, a nonprofit research organization, surveyed 2,504 doctors in May and June, 61% reported “often experiencing” burnout associated with financial and emotional strain. Two percent said they had retired because of the pandemic; another 2% had closed their practices.
Twenty-three percent of the doctors surveyed said they’d like to retire during the next year.
Baby boomers, like me, whose medical needs are intensifying even as their longtime doctors bow out of practice, are most likely to be affected.
“There’s a lot of benefit to having someone who’s known your medical history for a long time,” especially for older adults, said Dr. Janis Orlowski, AAMC’s chief health care officer. When relationships with physicians are disrupted, medical issues that need attention can be overlooked, and people can become less engaged in their care, said Dr. Gary Price, president of the Physicians Foundation.
My doctor, who’s survived two bouts of cancer, didn’t mention the pandemic during our recent visit. Instead, he told me he’s turning 75 a week before he closes the practice. Having practiced medicine for 52 years, 40 as a solo practitioner, “it’s time for me to spend more time with family,” he explained.
An intensely private man who’s averse to publicity, he didn’t want his name used for this article. With a skeletal staff — his wife is the office manager — my doctor has been responsible for 3,000 patients, many of them for decades. I know I’m lucky to have had a doctor I could rely on with complete confidence for so long. Many people don’t have this privilege because of where they live, their insurance coverage, differences in professional competence and other factors.
At each visit, my doctor would open a large folder and scribble notes by hand. My file is more than 4 inches thick. He never signed up for electronic medical records. He’s not monetizing his practice by selling it. For him, medicine was never about money.
Before a physical exam he’d tell a joke — a way to defuse tension and connect with a smile. “Do you know the one about …” he’d begin before placing his fingers on my throat (to examine my thyroid gland) and squeezing hard.
Which isn’t to say that my doctor was easygoing. He wasn’t. Once, he insisted I go to the emergency room after I returned from a long trip to South Asia with a very sore leg and strange pulsing sensations in my chest. An ultrasound was done and a blood clot discovered.
The young doctors in the ER wanted to give me intravenous blood thinner and send me home with a prescription. My doctor would have nothing of it. I was to stay in the hospital overnight and be monitored every few hours, efficiency and financial considerations be damned. He was formidable and intransigent, and the younger physicians backed down.
At that last meeting my doctor scribbled the names of two physicians on a small sheet of paper before we said our goodbyes. Both would take good care of me, he said. When I called, neither was accepting new patients. This is quite common.
Price, who’s 68, went through this when his family physician announced she was retiring and met with him in January to work out who might take over his care. Price was admitted into the practice of a younger physician with a good reputation only because he asked a medical colleague to intervene on his behalf.
Orlowski had a similar experience two years ago when searching for a new primary care doctor for her parents. “Most of the practices I contacted weren’t accepting new patients,” she told me. It took six months to find a physician — again, with the help of medical colleagues.
I’m lucky. A friend of mine has a physician daughter, part of an all-women medical practice. One of her colleagues, whom she recommends highly, had openings, and I got on her schedule in December.
Still, it will mean starting over. And these transitions are hard, for patients and doctors alike.
Several weeks ago I received a letter from my doctor, likely his last communication, which I read with a lump in my throat.
“To my beloved patients,” he wrote. “I feel so grateful for the opportunity to treat you and develop relationships with you and your families that I will always treasure. … I bid you all adieu. I hope and pray for your good health. I will miss each and every one of you and express to you my appreciation for so many wonderful years of doing what I love, caring for and helping people.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues.