The doctor is out: Erie sees increase in physicians retiring. Is this a problem for patients?

Dr. Sam Voora took care of Erie's tiniest babies for 40 years as a neonatologist at Saint Vincent Hospital.

Years after other physicians might have retired, Voora continued to treat prematurely born infants in the neonatal intensive care unit. Even after he ended his pediatric practice, Voora continued to work in the NICU.

Voora, 75, set a retirement date for June 2023 but then decided to quit in June 2022. The main reason was to spend more time with his grandchildren, who live out of town.

But the COVID-19 pandemic also played a role.

"It did contribute to my decision because it was another factor of stress," Voora said. "You had to wear an N95 mask for protection from exposure. It put a little more stress on the body, and I was already older than most other physicians."

Voora isn't alone. Whether it's due to age, the pandemic, job burnout or other reasons, so many physicians are retiring or will soon retire that a nationwide shortage is predicted within the next decade, according to a report by the Association of American Medical Colleges.

Though Erie County-specific data is not available, patients are already experiencing the effects of this mass retirement, said Dr. Tim Pelkowski, a member of the Pennsylvania Medical Society's board of trustees and Saint Vincent Hospital family medicine physician.

"We are already seeing it with some of the specialties, like rheumatology and dermatology," Pelkowski said. "I have had to send patients to Pittsburgh for dermatology appointments because of a lack of access here in Erie."

Primary care physicians also are retiring

It's not just specialists who are retiring, so are primary care physicians.

Dr. Richard Decker, a UPMC Hamot family medicine physician, had planned for years to stop practicing medicine at a relatively young age. Now 65, he retired in December 2021.

"My wife was retiring at around the same time and our plan was to travel," Decker said. "I phased out toward the end of my career, working half time as a float physician for Hamot's physician network."

Decker said he is not surprised to see other primary care physicians retiring. Many of them who went through Saint Vincent's and Hamot's family residency programs in the 1970s and 80s are reaching retirement age and beyond.

More: Erie dermatologist celebrates 50 years in practice with no plan to retire

Hamot ended its program in 2004, said Decker, who was an instructor in the program.

"In their heyday, those programs pumped out four physicians a year, many of whom stayed in the area," Decker said. "We don't see that now."

Hospital officials: Still plenty of PCPs

Officials with Saint Vincent and Hamot agreed that there are physician shortages in some specialties but pushed back on claims that there are not enough primary care physicians in the Erie area.

But more PCPs are retiring, said Lynn Rupp, UPMC's president of regional health services.

"We have seen an uptick since 2020, the start of the pandemic," Rupp said. "It's not a crazy amount, about 10% a year recently compared to 5% a year prior to that. So that's six physicians a year instead of three."

Saint Vincent is successfully replacing its recently retired physicians, said Dr. Christopher Clark, the Erie hospital's president. It hired 10 doctors in the first half of 2023 and has hired more in recent months, while Hamot will hire 12 in 2023 and early 2024.

Recruiting is a challenge, even though both Saint Vincent and Hamot are part of larger, Pittsburgh-based health systems, and despite the presence of a local medical school, the Lake Erie College of Osteopathic Medicine.

"It's about getting physicians and their families to want to live in the community," Clark said. "If the physician has a connection here, such as a family in the region, we are more successful."

More: Four decades and counting: Two Erie doctors have seen it all and have no plans to retire

Another challenge is dealing with young physicians, who have different preferences than previous generations.

"Many of them want to be in an employed situation, as opposed to being in private practice, so they can focus on treating patients," Rupp said. "They also care much more about a work-life balance. That has become even more important since the pandemic."

Health systems relying more on telemedicine, NPs and PAs

As health systems increase their recruiting efforts, they also employ other ways to treat patients. Two of the most popular are telemedicine, and the increased use of nurse practitioners and physician assistants.

Telemedicine has been used for years but increased in the first months of the pandemic when patients either couldn't, or were reluctant, to visit a medical office.

"Telemedicine will be a big part of the solution, especially in some specialties and in rural areas, though internet access is a big issue," Rupp said.

A growing number of local medical offices have added nurse practitioners and physician assistants instead of another physician to handle patient visits.

These providers can diagnose medical conditions, prescribe certain medications, order diagnostic tests and implement treatment plans, as long as they have a written collaborative agreement with a licensed physician.

"Having PAs and NPs work with an overseeing physician to make sure the office runs smoothly is an option," Rupp said. "Patients can see that they are getting great care from a knowledgeable health-care professional."

Keeping current physicians happy is important

Replacing physicians with nurse practitioners and physician assistants won't solve the problem. Besides recruiting new physicians, health systems need to keep more of the ones they already have, Pelkowski said.

"Physicians have to deal with so many things now that they didn't years ago, even in an employed setting," Pelkowski said. "Dealing with insurance companies and prior authorization for medications and tests, I think the burden tends to grow over time."

Decker, the recently retired family medicine physician, offered another stress factor: technology.

Whether they are part of a health system or still practice medicine on their own, almost all physicians now use electronic medical records systems and other computer software.

"The industrialization of medicine is a big change that I have seen," Decker said. "It started as a cottage industry, only for a few scattered specialists. Now you need an information system to get reimbursed by Medicare and the insurance companies. I can see how having to deal with this can be stressful, especially as you get close to retirement age."

Decker and Voora were both asked if they miss anything about their jobs.

"I miss the personal interactions with patients," Decker said.

"I don't miss the work itself, but I do miss the opportunity to work with the team: the nurses, respiratory therapists, pharmacists. Everyone was a joy," Voora said.

Contact David Bruce at dbruce@timesnews.com. Follow him on X, formerly known as Twitter, @ETNBruce.

This article originally appeared on Erie Times-News: Erie physicians join nationwide rise in retirement