Chapter 31: Retiring – from medicine, but not from life
|"It is not by muscle, speed or physical dexterity that great things are achieved, but by reflection, force of character, and judgment; in these qualities old age is usually not only not poorer, but is even richer. "|
Traditionally, practicing physicians saw no need to retire. Many feel that they are indispensable to their patients and the exalted role that physicians enjoy both professionally and socially is difficult to abandon. At most, aging physicians simply reduced their workload; and most retired only when forced to do so because of ill-health.
However, trends are now changing, and many doctors are choosing to retire. Some are being "pushed” to retire, because they are fed up of having to deal with the increasing hassles of providing patient care in the new millennium, and have burntout; while others are "pulled” to retire because they would like to spend part of their life enjoying themselves; they feel economically secure and want more time to enjoy other things in life, such as their grandchildren
Remember that just like you can start your career when you feel the time is right – at the age of 25 or 30; you can also retire when you feel the time is right. There is no magic number at which you should retire, and many physicians have continued to lead productive lives practicing excellent medicine to the ripe old age of 90 too ! Most doctors never retire officially – after all, why waste all those years of accumulated experience ? As you become more senior, it is also likely that more and more patients will start to seek you out, and if patients need your services, why should you refuse to give them the benefit of your many years of knowledge ?
What can physicians do to make the last one or two decades of their lives enjoyable? Retirement is your final career and requires every bit as much thinking and planning as your other career decisions. Ask yourself: What would you do if you did not have to work for a living ? What you would like to leave behind for posterity ? Where do you want to live? How will you use your time so you feel productive and inspired? What are your interests? What role will your family play? Do you want to be closer to your children—or farther away? You also need to prepare for a possible decline in health—your own and that of your family and loved ones. It’s also important that you have a plan in place as regards your clinic . If you want to sell it, the best time to do so is when you are still in active practice, so that you can capitalise on your professional goodwill. Many doctors find that taking in a junior partner, who will then buy you out in a few years when you are ready to retire, makes the transition as smoothly as possible. Don’t retire until you have enough financial security to lead a life of comfort; and enough financial reserves to cope with emergencies. Otherwise you may find that you are financially dependent upon your children, and this can be very uncomfortable, especially if you have been used to being the breadwinner all your life.
Planning for retirement and being ready for it emotionally are often two different things, particularly for physicians. Many doctors resist retirement but lingering in the profession too long can be tragic. Don’t wait till colleagues and patients start talking of you as a doddering old fool. Doctors who find the idea of retirement uncomfortable have become so used to seeing patients day in and day out, that they really don’t have much of a life outside their clinic. They are much happier being Dr Desai, rather than being the old man who lives up the street. And their self-esteem is so closely tied to their "being a doctor”, that they are not happy to let this go. This is why while many physicians look forward to retiring, others dread the prospect. Upon retirement, they mourn the loss of their position - not just among their colleagues , but in society as a whole. No one seeks you out for your medical skills anymore – and you soon learn the hard way who your real friends are ! You may feel diminished because all you have is your money – and your memories. For most people, it is normal to feel a loss of identity upon retirement, but physicians may feel this most strongly. From the time we enter medicine, we are told that the most important thing in our lives is our patients - before wife, children and family. No wonder we have such difficulty when we leave our patients behind. For many doctors, the clinic provides a daily place to go. If you suddenly have no place else to be, it can be a loss.
While many physicians worry about what the quality of their lives will be after retirement, the good news is that studies show that retirement has a predominately positive impact on the emotional state of physicians. Many are happy to be relieved of the demands of practice, and also enjoy indulging in pleasurable activities such as travel, leisure sports, dabbling in the stock market and playing with their grandchildren. Retirement allows more time for physical exercise and health may actually improve during retirement. However, about one-quarter of physicians will experience some depression after retirement, because of their sense of loss of self-esteem; poor health; diminishing cognitive skills; or unhappy marital relationship.
Retirement is easiest if work isnt the only thing that gives you satisfaction in life. If all you have done is just work at your job your whole life and then you suddenly retire, thats an acute loss. However, if youre involved with your family, have hobbies and multiple interests, and participate in your community, when you retire you lose only part of your emotional investment. The best preparation may be simply to expect some stress from the transition to retirement. For many doctors, that first year is a difficult period, but after that, most of them happily integrate themselves into their new life.
Once you retire, your most important relationship will be with your spouse , and this will be a reflection of your lives together. A non-supportive spouse will never find a friend waiting for him in retirement. Make sure you do your homework well in the thirty or forty years prior to retirement. Dont suddenly expect to find a good mate waiting for you in retirement - especially if you werent a good mate. Interestingly, the marriage often becomes stronger after retirement, because the couple spends more time together, and become more dependent on that relationship as a source of support, as they grow old together. In fact, a third of physicians felt that their retirement years were the best years of the life, and were as good as they years they spent courting, gaining professional status, and attaining financial security.
A successful retirement may depend on identifying what really matters to you, and then keeping those aspects alive. This is the one time in your life when you can do things purely for yourself. You can enjoy yourself and goof off, without feeling guilty about it ! It’s most important to remain intellectually active . Without this, the human organism withers and dies. The good news is that you no longer need to focus exclusively on medicine. You can now pursue whatever interests you – whether it is a hobby; or a completely different profession . Learn for the sake of learning, because it is enjoyable ; and it’s a good goal to try to learn something new every day. Don’t use your age as an excuse to stop learning – the brain remains as young as you choose to keep it !
Consider your body, mind, and spirit and take reasonably vigorous exercise in each area. What’s true for your brain is even truer for your body, because if you don’t use it, you will lose it. Physical activity is another necessity , and having a sport you enjoy can be a huge blessing. Along with your mind and body, remember also that we all have a creative side to us, and we need to exercise this to maintain full health. There are many creative activities on offer if we dont already have some, or are seeking something new, and plenty of available information. A balanced portfolio would include two inside pursuits for inclement weather, two outside for fresh air and exercise, two solo for peace, and two in company for stimulation.
You can now be financially relaxed , because you are no longer under any pressure to earn more money or keep up with the Joneses. The good news is that you can shed the administrative aspects of medicine, but keep on helping patients. Since you are a doctor, and there will never be a shortage of patients, the good news is that there are many opportunities for volunteer work and charity work for doctors, no matter what your age. You can be true to yourself, and as eccentric as you please, because you don’t have to put on a show for anyone else anymore.
Growing old can be difficult to cope with; and most of us have been so used to giving orders and taking care of our patients, that we can find it hard to let anyone else take care of us. You may also find you are socially isolated, because you may have distanced yourself from friends and family in your professional pursuits. It may be difficult to pick up these threads – but the good news is that there is a whole new generation of grandchildren you can become friends with !
Hinduism very wisely described the four stages of life – the four dharmas. Once you retire, you have reached the vanaprastha stage. However, you don’t need to retire to the forest and live as a hermit. Instead, you can use this stage to serve as a mentor to your juniors; and give back to your community what it has given to you. You need to start preparing for the end of your life, and you will find that serving others unselfishly is the one thing in life which can give you the most happiness. You have now become an Elder, and can provide guidance and advice to the Youngsters. You have now become wise, after years of hard knocks and weathering life’s ups and downs and have a chance to share your wisdom with the world, since you are no longer in the rat race. Your motto should be to grow from ageing to sageing, so you are a respected elder in the community. It’s nice to be respected, but remember you have to earn that respect to deserve it. Not having to do things with a vested interest or for purely selfish reasons can be very exhilarating – you can now finally learn what freedom really means !
This is also an excellent chance to get ready to make peace with yourself, and prepare for the final stage of life - dying and death. You can explore your spirituality, and do things just for yourself, so that you can make this stage of your life the most important and the most satisfying.