Retiring from medicine: The best of times or the worst of times?

The end of a long medical career and ensuing retirement is an interesting time in our professional lives. While retiring from medicine can be Heaven, it can also be Hell if not properly managed. Likewise, retirement can be just as Heavenly or it can simply be Hell v. 2.0.

In the coming months in this column we’ll discuss some (by no means all) of the social, financial and emotional considerations that separate a successful winding down and departure from a disastrous exit (for you and for everyone else). For the record, I retired preemptively two-and-a-half years ago at 64, about three years shy of my planned exit date, due to a “narrow-band” but career-ending disability. My departure was a little more abrupt than most, and I’m still not sure whether that made it easier or harder.

In this column, I’ll try to speak from experience, both mine and that shared by my peers, and from observations made over the course of 40 years as a physician. These are personal opinions and observations – your mileage may vary.

My hope is that this forum can be somewhat interactive. I would love to have comments or suggestions or personal experiences to provide as broad a perspective as possible. You can contact me directly or through The DO ([email protected]) with these or with topics you’d like to see discussed.

I’m going to start with some observations on physician retirement.

Retirement is a loss.

And I believe we may grieve for it the way we would any other loss. Perhaps we each grieve in our own way, with greater or lesser sorrow. When you’ve devoted your life to something, saying goodbye to it is probably not going to be easy – unless you either picked the wrong profession or, over time, you’ve come to loathe it.

A certain amount of cynicism and frustration toward the end of a modern medical career is natural – there are more hospital administrators than ever now and rarely do they make our jobs or lives more fulfilling. If you’re like me, you’ll miss these interactions about as much as you’d miss a root canal without anesthesia.

But for most of us, being a doctor was one of the best things in our lives (hopefully there were other best things too). Even after we’ve dropped the scalpel or the stethoscope, we’ll probably still be referred to as “Doc” and refer to ourselves as “Doctor.” It is more than what we do or we did, it is or was something that became woven into the fabric of who we are. Separating those threads out and cutting them on a single, specific day is never going to be easy, whether we dread retirement or can’t wait to get there. Think of it as a professional “phantom limb” syndrome.  Even though it’s gone, it will feel like it’s still there, at least for a while and maybe forever.

If we accept the construct of retirement as a loss that we grieve, it makes one wonder if that grief mimics the stages Elisabeth Kubler-Ross described in her seminal work On Death and Dying, first published in 1969.  It might be a strained analogy, but let’s give it a shot anyway, using her named stages in her order as a framework:

DENIAL: I’m not really retiring/retired. I’m still welcome at the hospital or the office.

We might think this is not the case, but how often do we see retired physicians haunting offices, doctors’ dining rooms and physician lounges shortly after and even long after their “playing days” have ended?

ANGER: “Dammit Jim. I’m still a doctor!”  [Apologies to Star Trek’s “Bones” McCoy]

In retirement, this translates to the idea that we still have more to offer – and we surely do. The questions are, how much is it worth and does anybody really want it?

BARGAINING: Maybe I could just hang around and consult?

Sure, we could stalk the OR’s or the Clinic hallways as roving dispensers of sage advice, making insightful observations and the occasional difficult diagnosis like Dr. House. But it’s a niche market – and a very small one at that.

DEPRESSION:  After all I’ve accomplished, after all I’ve done, this is the thanks?

Look how many patients I’ve seen, look how much money I’ve generated for the [group, hospital, corporation], look at how absolutely indispensable I’ve been.  And suddenly I’m not necessary anymore? Guess I’ll eat some worms.

ACCEPTANCE: Wait, you mean I can go to bed and no one is going to call and wake me up?

I don’t have to constantly do one thing at the expense of another? We can take ONE car somewhere? Seriously? Well, maybe I will give this thing a chance for a couple months and see how it goes.

Did you go through something similar?

As noted, it’s a bit of a strained analogy but not an altogether inaccurate one, I think. If you are retired like me, take a hard look and see if you didn’t go through something similar. If you’re not, look around and see if it isn’t at least a little true in what you see.

If you loved practicing medicine the way most of us have, you can’t just turn it off. But, maybe, Frankie Valli and the Four Seasons had it wrong – maybe there is some good in that goodbyein’ after all. In future columns we’ll try to find it, and in my next column, I’ll be writing about “Second Life” and second acts.

Related reading:

Considering call: It’s not the work, it’s the worry

How old are you in ‘doc years’?