North Carolina now declares physicians’ licenses “inactive” when those physicians have dropped out of active practice for two years or longer.[1]  Other states are considering similar changes in medical licensing regulations.  Re-entering practice can become quite difficult for pediatricians.  The AAP is studying this issue and trying to construct helpful protocols for pediatricians who see the need to take extended leaves of absence/sabbaticals from practice.  Holly Mulvey, MA, (hmulvey@aap.org) Director of the Division of Graduate Medical Education and Pediatric Workforce at the Academy, gave an interesting presentation on this topic to the Committee on Pediatric Educations recently. 

In her presentation, Ms. Mulvey summarized survey information involving 330 primary care physicians.   51% of these physicians have taken a leave of absence or sabbatical from medicine and the leave of absence/sabbatical averaged three and one-half years.  66% of these physicians were female.  The ages of the majority of the physicians were between 31 and 60.  60% of these physicians have considered re-entering medicine.  50% of these physicians were general pediatricians and 40% were family physicians.  More complete information concerning this issue can be found on the following AAP website: http://www.aap.org/GME.

I have recently become the Chairperson of the Advisory Committee to the Board on Education at the Academy.  It is my opinion that the Academy needs provide helpful information for its members who are contemplating taking leaves of absence/sabbaticals, or who are attempting to re-enter the practice of pediatrics, because state-licensing boards may make life difficult for these members of our profession.

Given the current state of affairs, I would recommend that pediatricians think twice before deciding to take leaves of absence/sabbaticals from practice. Pediatricians considering taking extended leaves of absence/sabbaticals should consult their state licensing agencies to learn of problems that may arise when they attempt to re-enter practice.   It may be possible for those pediatricians to develop part-time practice arrangements so that they are able to work enough to avoid being classified “inactive” by state licensing boards.  Medical malpractice insurance may become quite expensive for these part-time pediatricians and the AAP may be able to devise a program that meets the medical malpractice needs of these pediatricians, especially if these pediatricians work less than 20 hours a week in ambulatory settings and do not provide on-call or inpatient services for patients. I will ask the Advisory Committee to the Board on Education to continue to study this important issue, and will suggest that our Board of Directors work with Ms. Mulvey and the Department of Education at the Academy to devise helpful resources for pediatricians who are considering extended leaves of absence/sabbaticals from practice.

I welcome your input on this issue, or any other issue that needs the attention of our Board of Directors.