title: A systematic review of physician retirement planning.
abstract: Physician retirement planning and timing have important implications for patients, hospitals, and healthcare systems. Unplanned early or late physician retirement can have dire consequences in terms of both patient safety and human resource allocations. This systematic review examined existing evidence on the timing and process of retirement of physicians. Four questions were addressed: (1) When do physicians retire? (2) Why do some physicians retire early? (3) Why do some physicians delay their retirement? (4) What strategies facilitate physician retention and/or retirement planning?
  
  
  
  English-language studies were searched in electronic databases MEDLINE, Web of Science, Scopus, CINAHL, AgeLine, Embase, HealthSTAR, ASSA, and PsycINFO, from inception up to and including March 2016. Included studies were peer-reviewed primary journal articles with quantitative and/or qualitative analyses of physicians' plans for, and opinions about, retirement. Three reviewers independently assessed each study for methodological quality using the Newcastle-Ottawa Scale for quantitative studies and Critical Appraisal Tool for qualitative studies, and a fourth reviewer resolved inconsistencies.
  
  
  
  In all, 65 studies were included and analyzed, of which the majority were cross-sectional in design. Qualitative studies were found to be methodologically strong, with credible results deemed relevant to practice. The majority of quantitative studies had adequate sample representativeness, had justified and satisfactory sample size, used appropriate statistical tests, and collected primary data by self-reported survey methods. Physicians commonly reported retiring between 60 and 69 years of age. Excessive workload and burnout were frequently cited reasons for early retirement. Ongoing financial obligations delayed retirement, while strategies to mitigate career dissatisfaction, workplace frustration, and workload pressure supported continuing practice.
  
  
  
  Knowledge of when physicians plan to retire and how they can transition out of practice has been shown to aid succession planning. Healthcare organizations might consider promoting retirement mentorship programs, resource toolkits, education sessions, and guidance around financial planning for physicians throughout their careers, as well as creating post-retirement opportunities that maintain institutional ties through teaching, mentoring, and peer support.
authors.affiliation: Department of Anthropology/Health Studies, University of Toronto Scarborough Campus, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada. michelle.silver@utoronto.ca.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. michelle.silver@utoronto.ca.
authors.forename: Michelle Pannor
authors.initials: MP
authors.lastname: Silver
authors.affiliation: Department of Anthropology/Health Studies, University of Toronto Scarborough Campus, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Hamilton
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Aviroop
authors.initials: A
authors.lastname: Biswas
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Natalie Irene
authors.initials: NI
authors.lastname: Warrick
mesh_terms: D000367:Age Factors; D002055:Burnout, Professional; D006801:Humans; D007588:Job Satisfaction; D009042:Motivation; D010563:Personnel Turnover; D010820:Physicians; D012179:Retirement; D016526:Workload