Physician retirements are spiking.

American Medical Group Association (AMGA) and the healthcare recruiting firm Cejka Search uncovered the trend in their latest physician retention survey. The turnover rate of 6.8% among large group practices in 2013 was a repeat of that in 2012, and the highest rate since the 2 organizations launched the survey in 2004. However, the percentage of turnover attributed to retirement jumped from 12% in 2012 to 18% in 2013.

Ryan O'Connor, the vice president of membership and marketing at AMGA, said he wasn't surprised by the 50% increase in retirement.

"We knew physicians were putting off retirement when the economy went south," O'Connor told Medscape Medical News. "Now that it's stabilizing, all those physicians who were hanging on are finally ready to retire."

It's not just a stronger investment portfolio that's enabling physicians to say good-bye to the daily grind. A rebounding housing market allows retirement-age physicians to sell their homes at a reasonable price and relocate, perhaps to live closer to their children and grandchildren, said David Cornett, senior executive vice president of Cejka Search.

"They have the freedom to pick up their stakes," Cornett told Medscape Medical News.

Demographics and Discontent

Cornett and others have long reckoned on a flood of medical retirements as a consequence of the outsized Baby Boom generation — those Americans born between 1946 and 1964 — turning gray. Physicians in the "big bulge" of Boomers are now hitting their late 50s and early 60s, said Cornett.

Demographic-driven retirement is predictable. What's unpredictable is the rate of early retirement among physicians who are unhappy about government regulation, declining reimbursement, the bumpy transition to electronic health records, and the loss of professional autonomy. A survey released last year by the Deloitte Center for Health Solutions reported that 60% of physicians would retire today if they had the financial means to do so.

AMGA's O'Connor said this sense of disillusionment probably contributes to the jump in physician turnover caused by retirement. "There is a growing level of frustration," said O'Connor.

Cornett agrees. "All the changes in healthcare have been increasing the pressure for physicians to retire early," said Cornett.

While the physician turnover rate remains stuck at 6.8%, the revolving door for nurse practitioners (NPs) and physician assistants (PAs) is slowing down, according to the retention survey by AMGA and Cejka Search. Their turnover rate in 2013 was 9.4%, down from 11.6% in 2012 and 13.5% in 2011. Both O'Connor and Cornett chalk up this trend to the maturation of team-based medicine, one of the mantras of healthcare reform. Medical groups, explained Cornett, are doing a better job of incorporating and managing NPs and PAs. "They value them more," he said.

More than 40% of medical groups in the survey said that they want their NPs and PAs to practice as fully and independently as their licenses allow. Such clinical respect makes NPs and PAs more likely to stay put, said O'Connor.

"They do a lot more than they're used to," he said. "That's more satisfying than being relegated to lower-level stuff."The American Medical Group Association (AMGA) and the healthcare recruiting firm Cejka Search uncovered the trend in their latest physician retention survey. The turnover rate of 6.8% among large group practices in 2013 was a repeat of that in 2012, and the highest rate since the 2 organizations launched the survey in 2004. However, the percentage of turnover attributed to retirement jumped from 12% in 2012 to 18% in 2013.