Planning for retirement

Plan early

The age of 55 has been proposed as the latest age by which doctors should write a formal transition to retirement plan.¹ While retirement itself may be years away, planning early can lessen the emotional and financial toll of retirement.

Many doctors delay retirement planning, with fears of abandoning their patients, loss of collegiality with peers, boredom, financial stress, and relationship changes.

Delaying for too long carries risks. Having dedicated so much of your life to your practice of medicine, it would be a shame to end your career on a low note. Older doctors are at increased risk of physical and cognitive changes that may adversely affect their practice.²

Remember that retirement can bring new opportunities as well as time for hobbies, travel, family and friends. Speaking to former colleagues who have retired may be valuable.

"Suddenly stopping a busy professional life with tight timetables was a bit daunting — what am I actually going to do with all this free time? I needn't have worried — within a few months I had to restart a daily diary to fit everything in."

Dr Tom Hugh, NSW

General considerations

Your physical health

The physical demands of some specialties might lead to an earlier retirement. See your own GP regularly and look after yourself with your diet and exercise. Listen, if family or colleagues have concerns about your health.

Your mental and emotional health

Where possible, manage your workload to avoid burnout. Develop interests outside medicine. Consider establishing strong social networks and setting goals, e.g. increasing personal fitness; undertaking additional formal or informal education.

Your family's health

Sometimes a family member’s health may impact when you retire.

Financial preparedness

Obtain financial advice and develop a financial plan particularly if you are self-employed.

Easing out

Consider reducing your hours gradually; limiting patient numbers; not seeing complex cases; stopping one part of your work (such as out-of-hours or public work); or having the doctor who will take over your practice start working some sessions before you depart.

Transition to 'encore' work

Options include research; mentoring junior doctors; surgical assisting; and governance or management roles.

"I have kept busy being appointed to the Governing Council of the Country Health Service...and the local hospital boards. I also arrange conferences at the local rural clinical school and maintain an interest in the progress of former registrars."

Dr Ian Lishman, WA

Options for Ahpra registration

Maintaining Ahpra practising registration carries obligations such as CPD, recency of practice and mandatory reporting. Non-practising registration allows use of the title ‘medical practitioner’ – but you must not provide medical treatment or opinion to an individual including yourself, prescribe medication or issue referrals. Further information is available from Ahpra³ and the Medical Board.⁴

Actions in the months prior to ceasing practice

If you are an employee or a contractor:

• notify your employer/practice in accordance with the terms of your contract
• inform current patients (collaborate with the practice manager/department head about how to do this)
• arrange for the continuing medical care of all your current patients
• inform colleagues, Ahpra, Medicare, your MDO and your college (see notes on these below)
• know your HR entitlements
• arrange to have your details removed from practice/department websites and stationery.

If you are closing a practice

The Medical Board’s code of conduct⁵ includes this statement:

When closing or relocating your practice, good medical practice involves:

4.16.1 Giving advance notice when this is possible.

4.16.2 Facilitating arrangements for the continuing medical care of all your current patients, including the transfer or appropriate management of all patient records. You must follow the law governing health records in your jurisdiction.

Informing patients

It is important to give patients as much advance notice as possible. Communicate the date you will cease practice; whether you will sell or close the practice; options for ongoing care; and how to arrange transfer of records. 

If it is appropriate to do so, you can tell patients about your plans:

• during consultations
• in notices posted in the practice
• in website or social media posts
• by post or email (as per usual method of communicating with patients).

Sample letter to inform patients

Dear [patient name]

I appreciate the trust you have shown in allowing me to provide for your medical needs.

I am writing to announce the closure of my medical practice OR I am retiring after many years of practising medicine.

My practice will close for patient appointments on [date]. No medical services will be provided after this date.

If no doctor is taking over your practice:

For your ongoing health care, you will need to see another GP [or type of specialist]. Give details of how patients may go about this, such as seeing another doctor in the same practice or getting a referral from their GP.

I will be happy to provide your new doctor with copies of the necessary records from your file. Please sign and return the enclosed authorisation along with your instructions about where to send your records, and return it to my office no later than [date].

After this date, all requests for medical records should be sent to [address and/or email address].

If a doctor is taking over your practice:

I feel fortunate to have found Dr [name] to take over my practice.

Dr [name] trained at [training organisation] and has worked as a [position held] for [duration] years.

Dr [name] will begin working with me on [commencement date].

If you are visiting the practice before I leave, I will be pleased to introduce you to [him/her/them]. Your medical records will automatically remain with Dr [name] unless I receive written authorisation (form enclosed) from you to transfer them to another doctor.

Once again, I am grateful for the opportunity to have been your [doctor/specialist].

Yours sincerely
[signature]

In Victoria, you must publish a notice in a local newspaper (if one exists) and in non-English newspapers, if many patients are non-English speaking (unless you are a radiologist or pathologist); place a notice in the practice; and inform all current patients in writing.⁶ Any fee for access to records must not exceed a prescribed maximum fee.⁷

In the ACT, a notice in a daily local newspaper (including where records will be held and any fees payable for records transfer) and informing ACT Health are required.⁸

"Looking back [I wish I had] communicated better with patients and colleagues with explanatory and especially 'thank you' letters"

Professor John Murtagh, VIC

Continuity of medical care

This depends on what will happen with the records, but a formal handover to another doctor may be needed for complex patients. Ideally, it’s best to stop seeing patients or ordering investigations well before finishing up; or be available to review incoming results for a short time afterwards.

Where you plan to delegate the responsibility, a formal arrangement with your colleague is helpful (e.g. copying in a colleague to the results). The patients should also be informed about who will be following up the results. A pre-arranged and agreed understanding of what will happen is helpful to all parties involved.

Surgeons should cease operating in sufficient time before retirement, so that patients are not in standard postoperative review periods at the time you cease work. If patients have a My Health Record, you may be able to check or provide an updated Shared Health Summary or Event Summary.

Medical records

• If leaving a group practice where your patients will see other doctors within the practice, no specific arrangements are necessary.
• If the above does not apply, give patients the option of providing a copy of their records to a doctor of their choice or to the patients themselves.
• Records remaining in your possession should be stored securely for seven years from the date of last entry or, for a child, until the patient turns 25. Set up a simple manageable way for patients to access records after the practice closes (maybe a phone message about the practice closing; and tell them to email if they need to contact you or obtain records). You have 30 days to transfer records after a request.
• For storage of electronic health records, seek advice from the software company and your IT service provider.
• After the required retention period, you can delete or destroy records – but this must be done securely. If you use a commercial company, request a written record of its certification and written notification of destruction.
• In the ACT, NSW and Victoria, a register of date of destruction must be kept.

Informing others

Consider notifying

• colleagues, hospitals, pathology and radiology services
• Medicare (cancel your provider number)
• Ahpra
• your MDO. Ensure you maintain appropriate cover, particularly if you intend to continue your medical career in another capacity, such as teaching or medico-legal reporting
• your college.

Business arrangements

• Banking, including closing bank accounts and returning EFTPOS machines
• Leases and equipment
• Disposal of consumables and clinical equipment
• Utilities (telephone, internet, water, electricity, gas, alarm system) and mail
• Insurance policies (e.g. public liability, workers’ compensation, income protection, building and contents)
• Websites, domain names, and other IT systems
• Seek advice from an accountant about financial matters, such as tax and superannuation.

Medications and prescribing

• Dispose of any unused drugs appropriately – contact your state or territory drugs and poisons regulator.
• Destroy any paper prescription pads.
• Notify drugs and poisons regulators in your state or territory of cessation of practice, if you have a licence, e.g. S8 medication.

Employees

• Keep staff informed of your plans.
• Consider the need to retain one staff member in the immediate post-retirement period to assist you with administrative tasks.
• Employers’ obligations, such as those relating to tax, superannuation, termination payments and group certificates, are outlined in a guide from business.gov.au.⁹
• Return keys and practice-owned equipment.
• Retain employee records securely for seven years.

References

1. Wijeratne & Earl. A guide for medical practitioners transitioning to an encore career or retirement. Med J Aust 2021; 214 (1): mja.com.au/journal/2021/214/1/guide-medical-practitioners-transitioning-encore-career-or-retirement
2. Tsugawa et al & Thomas et al cited in Wijeratne and Earl (Ibid).
3. Ahpra. Registration: ahpra.gov.au/Registration.aspx
4. Medical Board. Medical registration – what does it mean: medicalboard.gov.au/Codes-Guidelines-Policies.aspx and Non-practising registration: medicalboard.gov.au/Codes-Guidelines-Policies/FAQ/FAQ-for-non-practising-registration.aspx#:~:text=This%20type%20of%20registration%20is,mental%20health%20of%20an%20individual.
5. Medical Board. Good medical practice: a code of conduct for doctors in Australia. medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx
6. Office of the Health Services Commissioner (Vic). Statutory guidelines on transfer or closure of the practice or business of a health service provider: hcc.vic.gov.au/sites/default/files/2021-04/hra_statutory_guidelines_transfer_or_closure.pdf
7. Vic Dept of Health. Health Records Act. Access to health records and maximum fees for access: health.vic.gov.au/legislation/health-records-act
8. ACT Health. Health practice closure, merger or relocation: health.act.gov.au/health-professionals/medical-professionals/health-practice-closure-merger-or-relocation
9. Australian Government Business. Manage employees when you sell or close your business: business.gov.au/people/employees/manage-employees-when-you-sell-or-close-your-business

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