To paraphrase General MacArthur, old doctors never retire, they just fade away. Despite having greater than average financial resources and more burdensome than average work load, many doctors seem to 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?
I think that some docs feel that it is somehow ignoble to leave the profession, that they would be abandoning their patients if they retire. Certainly many 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 master. Some enjoy the social status, diminishing though that it is, that comes from being a doctor. Some have matched their lifestyle to their income, and think they can’t do without the money that they are making. Some are hooked on the adrenaline rush 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.
Others are afraid to retire, or don’t know how to do it. An older doctor told me that he was afraid he would become senile if he stopped being a doctor. Implicit in this statement is the assumption that there is no other form of mental stimulation for a doctor other than being a doctor. Another physician told me he had no idea what he would do if he stopped working. I pictured him sitting in a chair at home, 24/7, with cobwebs forming on his immobile body. Do doctors invest so much of their heart and soul into medicine that, without the practice of medicine, they are nothing more than empty husks?
Like John Elway of the Denver Broncos, who retired after winning his 2nd Superbowl 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. Unless you believe in reincarnation, you only have this life to do the things on your bucket list.
How to retire? Check with your financial adviser. If he or she says you have enough money to retire you should strongly consider retiring. Sure you love medicine. But think about the parts you don’t love. The devastation that comes when a patient has a serious complication from a procedure. The threat of lawsuits. Maintenance Of Certification (MOC). Learning multiple electronic health record systems at different hospitals. Being called at 2 AM to go over drug reconciliation lists. Going through 8th grade level online fire safety training mandated by the hospital that now owns your practice. You get the idea. Even if you love medicine, I bet you don’t love it like you used to.
I retired this year at age 62. I finished medical school in 1976 and spent the intervening 38 years working as a physician, specifically as a cardiac electrophysiologist after I completed my fellowship. During that time I was on call probably an average of at least one night a week and had at most 2 weeks of vacation in a row (except for one time when I was off for a month between jobs). I like cardiac electrophysiology. I like the intellectual and technical challenges in the field. I got high from the adrenaline kick of being a highly specialized physician. But like any addiction, the long-term negative health hazards outweigh the short-term enjoyment, and as with drug addicts, the addiction takes over your life.
What can you do when you retire? All the things you neglected because the practice of medicine consumed your life. The day after I retired my wife and I moved to Paris, France. I am taking french lessons at the Alliance Française. There is nothing like sitting in a classroom again and making friends with young people from countries such as Syria, Iran, Poland, Brazil and elsewhere. I am also working on improving my programming skills, working on more mobile apps and expanding into web apps. Using the Internet, I am taking free online courses on subjects I am interested in, such as cryptography. I am travelling around Europe and seeing places I never visited before. I am reading books I have always wanted to read. I am living in a city where major concert artists come to perform regularly. I don’t miss the daily grind of medicine.
As Ian Fleming wrote, you only live twice. I’m liking my second go-around. If you are a physician reticent to retire, I urge you to take some time to think about all the things you like doing, or might like doing, but can’t do because of your work. Go back to school and learn something because you are interested in it, not because you have to. Think outside the box. Consider spending an extended period of time in another country. It is a great way to reboot your life.
Don’t become the cath lab cowboy who dies with his boots on.
We miss you but so glad for your new experiences.
You are living my dream life. Unfortunately I’m a family practice physician who owned her own practice and spend so much time trying to pay the bills that I never paid myself first (paid my employees first). So I’ll be one of those docs working past her prime.
I understand. The colleagues I was referring to were all specialists (cardiologists) who are reluctant to retire for the reasons given, but I’m pretty sure have the means to do so. I know that I am fortunate to be in this position. Family practice doctors are not reimbursed they way they should be, and reimbursements for all docs are diminishing. I guess my message is that there are plenty of good reasons to get out of medicine nowadays as soon as you are able.
I think that for the most part, doctors are a conservative group. Of course this is a only a generalization, but many of us fear change. We have always been the “good kids”. We received good grades throughout our academic careers and we worked hard in medical school. Frequently we went to medical school to please our families. We agreed to self sacrifice and, sometimes, to challenges so severe during our training that they have long-lasting effects that are not always desirable. Somehow we’ve been conditioned to believe that we’re more worthy as people if we agree to neglect ourselves. In short, we’ve done what we’ve been told to do. These personality traits persist throughout our lives. On retirement, (which, by the way, is the best job in the world), we’re scared as well. Often we’re too fearful to do anything daring or even unusual. I say, “What are you waiting for?” My advice is that you just take the plunge and do something about which you’ve dreamed. Just do it without taking years to weigh risks and benefits like the good little OCDs that we are. Strike “some day” from your vocabulary.
Of course those who really love being a physician and would rather do that more than anything else need not retire. However, if that doesn’t describe you, then get off the merry-go-round and stop allowing others to determine your destiny just because “that’s the way it’s supposed to be”. It’s OK to quit medicine. It’s OK to discontinue self sacrifice. It’s OK to be selfish at last.
I read this several weeks when my wife and I were cycling thru Puglia and contemplating doing exactly what you have done. I think you have given me the nudge I needed. I left patient care cardiology 14 years ago to learn and then teach CTA as a model of new technology needing to find a home in our toolkit. So I have stayed sharp in atherosclerosis, but notice lately how instinctively I hit the delete key in all the blogs and cardiology notices of things I need to know. Thanks for the nudge.
Dave. This really resonates with me! I hope to do the same sort of thing in a few years. Let me know how you are doing in a private email.
That was a great article. I’m also 62 years old. At the end of January I also will retire from being a pulmonary critical care physician. My biggest reticence has been that I’m not sure what will happen to the many patients that I’ve cared for, some more than 25 years. I know they will find other doctors . I would like to think that no one will care for those patients the way that I cared for them. That probably will not be true either.
I love the quote from Fleming about you only live twice. I believe that to be true. I’ve served my patients well. I’ve done the best that I could. I spent countless hours in the intensive care unit with patients and family members. I hope that none of my patients are upset. I can only wish them well. It is truly time to look more closely at my own wife and children and grandchildren and make up for the many hours that I was gone when they were growing up. I thought that my wife and I created a pretty fantastic life for them. I hope that as they become parents. They will see that sometimes those sacrifices needed to be made for a greater good down the road. I love the fact that you moved to France.
Thanks for your comments on this post. It’s now almost 3 years since I wrote this. I am now 65. How time flies! I basically still agree with what my earlier self wrote. Fortunately I had excellent partners in my practice and I didn’t need to worry about what kind of care my patients would receive when I left. I know some patients missed me on a personal level (and vice versa), but this would happen regardless of the timing of retirement.
The main issue with retirement (now using the retrospectoscope) is the sudden drop in the level of work and responsibility that occurs. You go from 100 mph as a doctor down to maybe 20 or 30 mph. It can be somewhat of a shock to the system, perhaps like amphetamine withdrawal. So the important thing is to have plenty of projects, both physical and mental, to keep you going in retirement. That’s one reason we moved to France. It was something completely alien and exciting for my wife and me. We have kept this up, spending half our time in France and half in Colorado. Learning French has been a challenge, but is rewarding. I started as an absolute beginner when I arrived in France in 2014, and now I am at an intermediate level. Learning a language is a project that takes many years.
Good luck with your retirement and enjoy the time with your family that you have earned after all that hard work!
Thanks for sharing your experience and wisdom…we do gooders sometimes live our lives in chains…and don’t even know we have the key. James C. Graf m.d.
Excellent blog post. I am going to be 66 in 6 weeks and am retiring. I am an Emergency Physician and have been Medical Director for over 30 years. Emergency Medicine is totally a young person’s sport. Not many at all over 65. Can’t wait to be doing what I want to do and when I want to do it. Other doctors on duty will do a great job.
And by the way, most of the non EM physicians could be a whole bunch nicer to the guy or gal on the front line who is taking care of their patient at 2 am.
It is amazing how many physicians ask me what I am going to do every day after I retire. How about enjoy the rest of my life without having to concern myself with patient care for starters?