When did retiring from medicine become an ethical issue?

Apparently all doctors must practice medicine until the day the die.  Or so says Gordon Marino in a New York Times piece called “A Life Beyond Do What You Love.”  This article caught my eye, since I am currently trying to do “what I love,” having already lived a couple of lives doing “what I think I should love.”  I didn’t agree with everything the piece said about doing what you love, although I will agree that the phrase “do what you love and the money will follow” is pure malarkey.

Mr. Marino gives several examples of people who have changed their lives to do what they love, and one of these is Dr. John Kitchin.  Dr. Kitchen was a neurologist who worked for 30 years, realized it wasn’t any fun anymore, quit and moved to Pacific Beach, CA, where he rollerblades on the boardwalk all day everyday.  The regulars there call him “Slomo” because he rollerblades in slow motion.  Now he’s totally happy.  Somebody did a short documentary of him; you should check it out.  Of course the reason he can do this is because he worked as a doctor for 30 years.  But that’s not my point.

Of this doctor Mr. Marino says the following:  “But is it ethical for the doctor to put away his stethoscope and lace up his skates?”  Which also caught my eye for obvious reasons.  I’m not sure when retiring from medicine became an ethical issue.

I decided to write a letter to the editor about this sentence, but I got no love from the op-ed overlords.  So I’m giving it to you, dear reader, so that at least one person will read it.

To the editor:

In the Opinionator section on May 17th you published a piece by Gordon Marino entitled “A Life Beyond ‘Do What You Love.”  In it Mr. Marino uses as an example Dr. John Kitchin who quit his work as a medical doctor and spends his days rollerblading in California.  Of this doctor Mr. Marino says the following:  “But is it ethical for the doctor to put away his stethoscope and lace up his skates?”  I’m not sure when retiring from medicine became an ethical issue.

The definition of the word “ethical” has two elements.  The first is that the word indicates an issue pertaining to or dealing with morals or the principles of morality pertaining to right and wrong in conduct.  To say that it is unethical for a doctor to quit his job is to say that it is morally wrong.

Is it because we’ve invested so much time and money in our training that we are morally obligated to keep at it?  It takes at least as long to train an astronaut or a PhD.  Are they obligated to work forever also?  Perhaps if this were another country, such as France, where medical school and malpractice insurance are heavily subsidized by the government, one could argue that it would be wrong to take all that public money and throw it away.

But here in the U.S. we pay for our own education.  Perhaps it’s because we’re trained to take care of others: a sacred trust.  Sure, but so are nurses and physical therapists.  Are we morally obligated to take care of others because we can?  By that metric all of humanity is so obligated.

The second definition of the word “ethical” says that being ethical means being in accordance with the rules or standards for right conduct or practice, especially the standards of a profession.  Nowhere in the Hippocratic Oath does it say, “Thou shalt never quit.”  The American Medical Association’s Declaration of Professional Responsibility doesn’t mention retirement.

Doctors are held to many ethical standards, as they should be.  Working as a doctor forever is not one of those standards.

Shirie Leng, a former nurse, is a recently retired anesthesiologist who blogs at medicine for real.

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  • ninguem

    Time was, the “rationale” for excluding women from medicine, was that the education was too valuable to “waste” on a woman who would not be able to devote her attention to medicine 24/7/365, because of certain realities of childbearing and child-rearing.

    Give that valuable education to a man, who can work long hours, forever, until he drops.

    Anyone who has a problem with the “ethics” of a doctor who decided that 30 years of practice was enough……….that person finds himself in the company of certain sexist troglodytes of times past.

  • Sharon

    If one could afford to make that decision, particularly when feeling burnt out and/or distracted, more power to him/her. I would think it would be more ethical to leave than to stay in a field of work because you feel obliged or trapped.

    Psych. RN

  • Shirie Leng, MD

    Point well taken. I think, though, in the case of Kitchin specifically, 30 years is probably fulfilling his duty to collective society.

    • Dr. Drake Ramoray

      Agreed by any rational measure.

  • NewMexicoRam

    Who cares?
    When I think I have enough finances saved, I will retire.
    I’m sure I will do something else for a while, keep the brain stimulated and interact with people, maybe even volunteer work.
    The last 14 years (with government intrusion, electronic record hassles, threats of 2 malpractice suits that were ridiculous and without merit, and low pay) have not been enjoyable. Stealing the most productive years of my career.
    There’s one thing I fear: that buried somewhere in the 2000+ pages of ObamaCare, there is a regulation that primary care physicians cannot retire. And, no, I will not take the time to read it to find out.

  • Dr. Drake Ramoray

    Agreed, yet somehow these ideas are taken seriously. The whole policy makers spewing this “managing populations” garbage (several posts on this site), and ACO/PCMH stuff is taken seriously. It isn’t too much of a stretch from “managing populations” and dismissing the individual physician/patient relationship to the exact fundamental agreement in the statements that you and I have shared.

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