Practice Economics

For doctors who take a break from practice, coming back can be tough


 

References

In the end, she received two certificates – one from the program and one from the University of California, San Diego, for 180 hours of continuing medical education.

“I definitely felt more confident,” Dr. Gibson said. But she still wanted more hands-on clinical training. So she recently started a paid family medicine fellowship at the University of Southern California, seeing patients under the oversight of other doctors.

Former medical school professor Dr. Leonard Glass created the San Diego program, called the Physician Retraining and Reentry Program, in 2013. Besides retraining primary care doctors, the online program has attracted specialists who wanted to switch to primary care, as well as some restless retirees.

“Some are simply tired of being retired,” he said. “It’s sort of an itch to go back to taking care of people.”

‘Expensive and time consuming’

Several retraining programs are run by hospitals, including Cedars-Sinai Medical Center in Los Angeles. There, participants spend between 6 weeks and 3 months seeing patients under the supervision of other physicians, then discuss their cases in an exit interview to demonstrate what they learned. They leave with a letter that can be submitted to employers or hospitals.

The Cedars-Sinai program costs $5,000 a month. Dr. Leo A. Gordon, who runs it, said some doctors who call to inquire are angry about having to spend the time and money when they already have so much education and experience. But he said others are simply appreciative that “there is a way to get back in the game.”

One Cedars-Sinai graduate, Dr. Maria DiMeglio decided she wanted to return to practice as an ob.gyn. after taking off almost 6 years to care for her children and her ill mother.

“I thought I was retiring, Dr. DiMeglio said, “but I kept my options open.” She had retained her medical license and kept up with continuing education courses. But she needed to persuade her old hospital, Cedars-Sinai, to give her privileges so she could perform surgeries. The Cedars-Sinai retraining program, she said, “wasn’t difficult, but it was expensive and time consuming. Not everyone can do that.”

Hospitals set their own requirements for doctors to get credentials and privileges, but doctors who have been out of practice for more than 2 years generally must show that they are competent to see patients. Having a certificate from a reentry program helps, said Dr. David Perrott, senior vice president and chief medical officer of the California Hospital Association.

Dr. Jeff Petrozzino, a 50-year old doctor who trained in pediatrics and neonatology, knows all about that. He ran into difficulty returning to clinical practice after spending several years doing health economics research.

“I was a double board–certified physician licensed in several states,” he said. “You would think I would be able to get a job.”

When he finally did get an offer at a medical center in New Jersey, he said both the position and the state medical license were contingent on him getting retrained. He completed a 2-month program at Drexel University in 2013, where he was surprised to discover many other doctors in a similar situation.

Dr. Petrozzino said he was grateful for the program – but given the hassles of reentry, he would advise doctors to plan carefully before taking a break from practice.

“Careers are interrupted or derailed for various reasons,” he said. “The system does not readily allow for reentry.”

Kaiser Health News (KHN) is a nonprofit national health policy news service. Blue Shield of California Foundation helps fund KHN coverage in California.

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