How can a physician retire gracefully?

Retirement is an intensely personal decision. I have done virtually nothing but medicine for the last 35 years. Oh sure, I have made some money from writing, or giving lectures and expert case reviews, but most of these are tied to medicine as well. Having just turned 65, my financial advisor says from his analysis, I can retire any time now. I have a contract with my cardiology group, which I started in 1982, through June 2014. I have announced to them, and my patients, my intention to retire then.

Now that the calendar seems to be in a fast forward mode, that date will be here in the blink of any eye. Friends, families, and patients, have disparate opinions of my plans. As most other things in life, those views are created from their own ideas surrounding the subject. In other words, their opinions mirror how they feel about retiring — not mine. I understand this. The most common question is not “Are you sure?” or “You’re too young or too old.” It is usually “But what will you do with your time?”

I have plans, but not a plan. Let me explain. As physicians, our lives are centered on structure and timelines. There are meetings, and patient appointment times, and starts times in the cath lab or operating room, etc. There are calls from nurses everyday that vie for your immediate attention, like “Mr. Jones has been waiting all day to go home. Can he be discharged?”

Thus, the last thing I want to do after retirement is to have too much structure. I want the opportunity to be spontaneous and more in the moment. With more of my life behind, than in front of me, moments have become sacred and precious.  Preoccupation with tomorrow is the thief that robs you of enjoying today.

I feel comfortable with my timing. I have seen the Golden Age of medicine come and go. I witnessed the rise and fall of HMOs, and their resurrection again. I have been paid too much for my services to now too little. I have lived through the corporatization of medicine, and barring a hail Mary event by organized medicine (and an epiphany by the American public), I suspect that our country is on the cusp of nationalized health care as well.  Obamacare may go down in flames, but without conservatives offering a coherent and unified alternative, I predict an increasingly un- or underinsured populace screaming for a single payer system. In fact, many on the right feel that was the plan all along.

I am reminded of a line from the book, “Man’s Search for Ultimate Meaning,” by Viktor E. Frankl, a neurologist and psychiatrist. It was, “Your work is not your worth.”

So many physicians’ only identity is that of being a doctor. It was this way for my father, who was a small town solo internist and practiced medicine almost up until the time when he died of cancer. His only other interest was investing. Therefore, in growing up, I had no role model on how to retire gracefully. By this I mean being true to yourself, your family, and your patients.

A good physician friend of mind offers a cautionary tale. Having just passed his 70th birthday, he announced his retirement last spring. Two months before his retirement he was diagnosed with Parkinson’s disease. Always physically active, he now faces his golden years doing rehab and going to one doctor appointment after another.

I don’t have a bucket list but have enough interests to keep me busy. Many of these are simple. I want to fish more before my body gives out, and learn a second language. I want to do yoga or pilates so I can bend without pain and touch my toes again. I want to travel and see my grandchildren. I want to garden, cook, read, and write.

Mostly, I want to step away from my doctor identity and take the time and joy to discover things I might have felt was too time consuming or small during my working life. As one of my nonagenarian patients said to me shortly before he died, “Every day I wake up is a bonus.”

No one can till you when to retire. You must listen to that still small voice within and then decide. I believe if you can do that, then you will know when you are ready.

David Mokotoff is a cardiologist who blogs at Cardio Author Doc.  He is the author of The Moose’s Children: A Memoir of Betrayal, Death, and Survival.

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