Andrew Wilner, MD, FACP, FAAN, offers his advice for physicians nearing retirement who may want to keep their options open after retiring.
Does a doctor need an active medical license after retirement? The obvious answer is “no.” Why bother with the expense and hassle of maintaining one or more medical licenses if you are retired? Many state license renewals require mind-numbing paperwork, a hefty fee, and 20 hours or more of continuing medical education (CME) per year.
The cost and the bother
If those requirements don’t give you pause, some medical license renewals prove even more burdensome. For example, the Florida Medical Board requires CME credits in controlled substance prescribing, domestic violence, human trafficking, and medical errors. Just locating these CME courses can be challenging, never mind completing (and paying for them)!
While most states settle for a statement (subject to audit) that you have performed the required CME, Florida demands copies of each CME certificate! Every two-year renewal cycle, you must upload all 38 required hours of CME to the official website, including the specific courses listed above.
Florida also exacts an annual $250 payment to its birth-related Neurological Injury Compensation Association. Even a neurologist like myself, licensed in Florida but not working in the state, must pay this annual fee.
Trying to keep a medical license active may trigger additional aggravations, like renewing fingerprints as required by the Florida Medical Board. If you don’t pay the $42 “fingerprint retention fee” every five years, you must redo your fingerprints at an authorized scanning facility or submit hard copies.
Another cost of keeping an active license is professional liability insurance. For example, if you have an active medical license in Massachusetts, you must pay for malpractice coverage with a minimum policy of $100,000/$300,000, even if you don’t practice!
If you have retired, medical licenses no longer qualify as business deductions on your tax return. These expenses add up. For example, because I worked locum tenens at the Mayo Clinic in Phoenix, AZ, I obtained an Arizona license. Renewal costs $500 every two years. At one point in my locum tenens career, I held ten licenses, each with CME requirements and renewal fees!
Once retired from the practice of medicine, your medical license is no longer necessary. It’s a big time-sink and a money drain. But before trashing the renewal form, you have to answer one crucial question: “Is there a chance I will return to clinical practice?”
Countless physicians have retired, only to return to clinical practice. If there is even a small chance that retirement may not be permanent, do NOT let your license lapse. It may be a Herculean struggle to get it back.
Here’s an example: Many years ago, I failed to receive my Massachusetts medical license renewal form in the mail because I had recently moved. By chance, I discovered that the license had expired two days after the renewal deadline. I immediately called the Board and offered to FedEx a check and the renewal form. However, since my license had expired, the Board informed me that I would have to complete a “lapsed license application”! When I inquired why they made no effort to contact me by email, phone or text, I was told, “We are too busy to deliver personalized service.”
The Board insisted that all usual licensing requirements would have to be resubmitted, even though these were presumably on file. The Massachusetts Board states on their website, “An application for renewal of a lapsed license is complicated...” As opposed to the renewal fee of $600 every two years, I would have to pay a $700 “lapsed license fee,” even more than the standard application fee of $600! The average time for license processing is 16 weeks. Had I had been practicing medicine in Massachusetts, I would have had to suspend my clinical practice or risk “practicing without a license”! All because my renewal was two days late!
Here’s another example: About twenty years ago, I obtained a Florida license because of an attractive practice opportunity, but that position didn’t materialize. If my Florida license expired and I tried to get a new one after two or more years in retirement, I would have to take the 6-hour Special Purpose Examination (SPEX) exam!
Malpractice insurance after retirement
I’ll add that an active medical license, while necessary, is generally not sufficient to get back into practice. In most cases, clinicians must also carry malpractice insurance. If you have been out of practice for two years or more, it may be IMPOSSIBLE to get insured. Don’t slip into that trap!
If you are ready to retire but don’t want to burn the bridge back to practice, locum tenens can help. Each assignment resets the two-year clock for malpractice insurance. Staffing agencies happily pay malpractice premiums and relevant license costs for locum tenens work.
Locums will supplement your income in retirement and allows preservation of your physician identity. To learn more, chat with a staffing agent at CompHealth or another National Association of Locum Tenens Organization (NALTO) member agency. Here’s a link to a helpful YouTube interview with an experienced locum tenens staffing agent. Ask to speak peer-to-peer with a locum tenens physician. If you try locums and like it, you may never retire!
Retirement represents a disruptive change in status for physicians who have dedicated their lives to their careers. According to the American Medical Association, many physicians keep their medical licenses for two to five years after retirement, just in case they return to practice. Because medical licenses are so painful to obtain, I wholeheartedly concur with that advice!