THE LATE-CAREER PHYSICIAN

General McArthur once said, “Old soldiers never retire, they just fade away.” Older physicians would like to stay connected to the practice of medicine, and if they have to fade away, they have as a goal to leave with their reputation intact.

The retiring physician is usually in his or her 60s and is focused on winding down the practice by doing less and having less responsibility. Retiring is not easy and creates challenges for doctor and the practice. While many retiring physicians are on “auto pilot” and yearn for the good ol’ days of autonomy, independence, and fee-for-service, the reasons that doctors are leaving include:

• Economic factors such as medical malpractice insurance, overhead, and electronic medical records;

• Healthcare reform;

• Burnout;

• Pursuing different career paths outside the practice of medicine;

• Lifestyle choice;

• Age 65+;

• Health reasons; and

• Financial ability to retire—the best reason of all.

Many doctors have a hard time knowing when it is time to call it quits. I know doctors who continue to practice into their 70s and 80s. Some continue to work until the day they die. Why is this? Many fear retirement, which represents an unknown future. They don’t know what they are going to do for 40–50 hours a week when they stop practicing medicine.

I think that some doctors believe that it is somehow ignoble to leave the profession, that they would be abandoning their patients if they retired. If a doctor has provided care to the patient for decades and has cared for other family members, there will be an attachment that neither the doctor nor the patient wants to end.

Certainly, most doctors enjoy what they do, deriving a sense of satisfaction from their work. They take pride in their skills that have taken thousands of hours to hone and to master. Some enjoy the social status that comes from being a doctor and they worry that their social ranking will be gone when they retire. Some have matched their lifestyle to their income and think they can’t do without the revenue. Some are hooked on the sense of accomplishment and euphoria that comes from opening a clogged artery in the middle of the night and saving a life, or ablating an arrhythmia and changing someone’s life for the better.

One of the most difficult challenges facing the retiring physician is moving from a structured life that he or she has led for over four decades to an unstructured life where there are no meetings, deadlines, or calls to return.

As physicians, our lives are centered on structure; we are addicted to the clock. There are meetings, and patient appointment times, and starts times in the cath lab or operating room. There are calls from nurses and patients every day that vie for our immediate attention.

The challenge that most retiring doctors face is having so much unstructured time that they are bored. This requires balance between structured time and unstructured time that is necessary to provide stimulation without the requirement of responsibility.

These are just some of the reasons doctors are afraid to retire, or don’t know how to do it. In Chapter 13 of The Three Stages of a Physician’s Career: Navigating from Training to Beyond Retirement, we discuss how to proactively prepare yourself for retirement, or “protirement.” We suggest a plan of action for health, meaning and stimulation in retirement. Our goal is to help the retiring doctor transition from the practice of medicine to years when he or she can enjoy the well-deserved fruits of the labor of their medical career.

Every profession faces issues associated with leaving the profession and moving on to something else for which they have no training or skills. The accountant, the lawyer, the dentist, and even the young professional athlete has concerns about moving to the next phase of life that doesn’t involve the skills and training that is required to be a professional. Like John Elway of the Denver Broncos, who retired after winning his second Super Bowl title, it is better to retire at or near the top of your game, rather than hanging on until your skills diminish and you have overstayed your welcome. Retire while you are still healthy and active enough to enjoy life. Don’t wait until it is too late.

Excerpt from The Three Stages of a Physician’s Career: Navigating from Training to Beyond Retirement

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