How physicians can retire the right way

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 Super Bowl 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 a.m. 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.

David Mann is a retired cardiac electrophysiologist and blogs at EP Studios.

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  • Dr. Drake Ramoray

    I know exactly zero doctors that want to work until their 70′s, 80′s or die at their desk. Between the corporatization of medicine and MOC I just don’t see it happening. Sure their will be some who haven’t managed their retirement correctly or got crushed by the great recession. I would wager my opening statement is true for any doc younger than say 50-55.

    • ninguem

      Over my career, I’ve seen four doctors who had to be pushed into retirement because they just would not stop.

      They were being pushed into retirement, because they just would not stop, they were completely dedicated. Problem was, they were physically sick, to where it was a threat to the DOCTOR’s health, let alone the patient.

      One, unfortunately, was ugly, threatening litigation.

      The other three were sad and joyful at the same time. They would work anywhere, for free, see the patients no one else was terribly interested in seeing. They ran the free clinics. I got some of my medical school education from them. They were overjoyed to have students.

      Retired ortho, OB/GYN, and general surgery, especially helpful. They would do a lot of the preop and postop work for the no-pay and Medicaid patients, it allowed the younger docs to do the surgery, with less of the preop and postop hassle. If they weren’t getting paid for the work, at least this minimized the hassle. The preop and postop work was being done by the semiretired docs that were the former chiefs, so the younger docs had confidence in the preop and postop care. They weren’t turning the patients over to strangers.

      One retired family doc ran the VD clinic, back when it was called “VD”, and I learned about Thayer-Martin agar and chocolate agar and all that.

      They had the institutional memory of the place. One had great stories of his work as an army surgeon in China, behind the Japanese lines with Pappy Boyington and company.

      Big party for the retiring docs, old pictures, tears, reminiscing.

      And they would show up at the doctor’s lounge for lunch…..back when there was a doctor’s lounge. The doctors, working and retired, some clergy and a few others would stop by. They would show up for continuing education as though they were studying for boards.

      Doctors lounge and dining room no longer exists. Who has time? The primary care docs like me, no longer stop by the hospital.

      The docs retire at a more “normal” age and never look back.

      The hospitals are hard-pressed to find the docs who want to care for a certain population of patients.

      We’re the worse off for losing the docs.

      Is that “progress”? I dunno……..

      • Lisa

        I work in academia. Your descriptions of the retired doctors remind me of our emeritus facilty. They are still very involved in research.

        Personally, I think many people retire too early. While there comes a time to cut back, they still have a role to play in their professions.

        • Patient Kit

          Retired and semi-retired docs also have the time to get politically involved in shaping the future of healthcare in the US. The question is: Do retired and semi-retired docs have the inclination to get involved in a doctor-patient movement to try to shape the future of our healthcare system?

          They may be at the end of their careers but they are now, more than ever, potential patients in our system. And then there is caring about the future of our healthcare system for their children, grandchildren and the American people in general. They are a valuable group that needs to be organized and mobilized. Personally, I’ve been involved in numerous political campaigns that benefited greatly from retiree volunteer involvement.

      • Suzi Q 38

        I think what you describe is great.
        The “retired” docs are still doing what they love to do and still feel important, wanted, and needed.

    • Suzi Q 38

      I have seen several “die at their desk,” mainly from medical conditions similar to the public that they serve. They are not immune from cancer, strokes, and heart conditions.

      Some died rather suddenly, and we had no chance to say “goodbye,” while others allowed us to visit them at the hospital.

  • Suzi Q 38

    I remember visiting a urologist who was 80+, still seeing patients, and still doing surgery. Staff worried that the would not be able to steady his hands while doing surgery…..He died on the job.

    One of my specialists is about 80. He has tried to retire once, I was told.
    He is still very good at what he does. He only sees patients once a week.
    He garnered points with me when he was late for our first office visit.
    My husband and I dutifully waited in a patient room for an extra 30 minutes after my appointment time. When he finally came in the room, he quickly apologized and told us the truth: That he was late because he forgot that he was supposed to be at work….that he was sitting at a restaurant having lunch with his wife and he remembered that it was not his day off.
    Whatever.
    He has finally ruled out a serious condition for me, and for that I am grateful. He said he wants to see me next year for “one more time. if he is still alive…”
    At least he has a sense of humor.

    No one can tell anyone when it is time to retire.

    Eventually as physicians age, they get offered fewer jobs, just like a lot of other people. Some can reinvent themselves and do something related and still feel fulfilled, while others choose to retire.

    Everyone can and will make their own decisions based on many professional and personal factors.

  • James O’Brien, M.D.

    How about a collective sabbatical until EHR and MOC are done away with and medi-mal reformed?

    A sabbatical in many ways is more enticing than retirement. I have no idea what my health status will be in 15 years.

    • Patient Kit

      A collective sabbatical? Is that anything like a (long) strike?

  • NewMexicoRam

    Once my financial advisor tells me I have enough to live on $70,000 per year, including inflation estimates of course, I will call it quits. Maybe I will do volunteer work or make money part-time doing something else, but I will not continue practicing medicine at that point. I am really done with it. All the tricks from the feds, the insurance companies, and the attorneys have completely soured it for me.

    • Suzi Q 38

      Good for you.

      Also, consider how long you may live.
      My mother is 90, and my husband’s aunt died recently at the age of 100.6 years.
      You may have similar luck, especially if you get to quit your stressful job.

  • buzzkillerjsmith

    EHRs have been mentioned by several docs here. I don’t think non-docs have any idea how much we hate them, how infuriating they are.

    I really think that getting scribes would keep a lot of docs working longer. We’ve had to do MOC for a long time in fam med, so it’s not that big of a deal for us. Sounds as if it is pretty horrible in int med.

    • jpsoule@hotmail.com

      I know fellow internists giving up their ABIM certifications due to ridiculous board and MOC requirements. Many others have no choice as they are in contracts requiring them. I have a good friend who wastes so much of his time maintaining board cert in IM, Gerontology and Palliative medicine he can not take his share of call. I got out of that group. And when they yank my certification you know what they can do with it.

      • buzzkillerjsmith

        Sounds horrible.

  • James O’Brien, M.D.

    Good for you.

    I especially like the fact that you went to a temperate zone developed country instead of a tropical paradise where you or any other intelligent/inquisitive person quickly would have become bored.

    • Patient Kit

      LOL! I guess you and I are polar opposites in many things. I consider myself to be a fairly intelligent and very inquisitive person but I would love to live on a tropical beach for a while and I would not get bored. First of all, I love the ocean and all things in it. I would be under the sea a lot where it is far from boring. I would be active with local environmental groups. I would spend my time writing a novel or two. And I would immerse myself in the local culture. Maybe this tropical paradise thing appeals to me because I’ve spent my entire adult life living in NYC, which I love. But a tropical paradise sounds heavenly and unboring.

  • Thomas D Guastavino

    From personal observations I would estimate that around 80% of docs over the age of 55 would retire if they could. Financial “misadventures” are whats stopping them. The usual suspects:
    1) Divorce (workaholic syndrome)
    2) Support of young children (starting families late)
    3) Overspending (Im a doctor, I deserve the country club)
    4) Debt traps (Buying your building instead of renting in a poor real estate market)
    5) Turning your investment decisions over to someone else (I don’t have the time)
    6) Penny wise but pound foolish decisions. (Think Claims Made vs. Occurrence Malpractice insurance)
    I know, I know, we need to be Doctors and be above anything as evil as making proper business decisions.

    • Patient Kit

      I hate to admit this because, in general, I’m not an ageist, but hearing how miserable and jaded many docs are, especially older docs, is making me consider whether I should avoid seeing docs who are 55 or older since so many of them apparently really hate being doctors and really don’t want to continue practicing medicine and would retire if they could.

      My current favorite awesome doc is in his early forties. He seems old enough to have some solid experience, but he does not seem jaded or miserable practicing medicine (although, who knows? maybe he just hides it well). But I generally have good instincts about people and can tell when someone is genuinely unhappy. And I generally listen to and trust my instincts.

      Going forward in choosing any new docs I might need to see, I wonder if it would be wise to look for doctors who are under 50 to increase my chances of avoiding docs who are burnt out and really hate being doctors at this point and are really not adjusting to our changing healthcare system.

      I hate that I’m thinking this because, in general, I’m really not ageist.

      • Thomas D Guastavino

        I know plenty of docs just out of residency who are already looking to get out. The important thing is to have the freedom of choice to pick your doctor. Once you find one you like you will see that age has nothing to do with it. In fact, some of the happiest docs I know are the ones who have planned well and can see the light at the end of the tunnel. They are the ones who have the freedom to be the docs they always wanted to be and their patients are much better off for it.

        • jpsoule@hotmail.com

          Damn straight. I enjoy seeing my patients because they want to see me. They tell me they pay extra because I treat them like people. Thats all it takes. The feds and insurance are driving solo practitioners into big groups or hospital employment or out of practice all together with all their requirements. I do not think this is coincidental, rather control.

        • Patient Kit

          Heh. I don’t know whether that makes me feel better or worse. I guess I’ll just stay with my usual MO and go by individuals, not by demographics of any sort, when searching for a new doc. It just seems like I’m hearing more about how unhappy the older generation of docs are now. I increasingly don’t see how a truly miserable doc can be a good doc so I really value the truly wonderful docs I encounter all the more.

          I guess the flip side to “more and more docs would leave medicine now if they could” is that more and more people (patients) I know are avoiding going to doctors as much as possible — especially for easy, uncomplicated issues’(the kind of patients some docs, apparently, much prefer). Maybe we won’t have such a shortage of primary care docs after all if more and more people choose the self-treatment movement over seeing a doctor who hates being a doctor.

          I’m especially thankful today for my awesome doc.

          • Thomas D Guastavino

            Good for you. Judge by the individual, not by the group. My concern is that patients freedom of choice has become another innocent bystander in the current health reform war.

          • Patient Kit

            My concern is that, if the vast majority of docs in the US — regardless of their age — are extremely unhappy practicing medicine in this country, that there will be precious few “good” docs for patients to choose, even if we retain the ability to choose our docs. I just don’t think docs who are this miserable can continue to be good at what they do, other than maybe technically. And that is a pretty depressing realization.

      • James O’Brien, M.D.

        Guess what? You doth protest too loudly. You’re ageist. Substitute “African-American” for “55 and older” in your paragraph and see if it doesn’t read racist.

        In fact, many docs over 55 have options, and many who are 20 years younger are trapped by student debt. It may be that older docs are just less afraid to think out loud. I’d say the docs who are most screwed right now and most ambivalent are ages 30-40. BTW, I’m not blaming them at all, they got a raw deal.

        Just because a doc maintains a happy public face (which they should do when seeing patients) doesn’t mean they aren’t privately distressed about the changes in medicine.

        • Patient Kit

          Believe me, as a fiftysomething woman, recent cancer survivor and current job hunter, I truly bristle at the idea of ageism. And I, in general, am really not ageist. I was just reacting to the constant assertion I read here at KMD that 80% of docs 55 or older would retire/quit if they could, which I take to mean that 80% of docs in that age group no longer like being doctors, even hate being doctors. Just saying that those who keep asserting that “fact” aren’t doing older docs any favors when it comes to public image and perception. Likewise to the extreme resistance to technology.

          Others here have convinced me though that young residents and docs aged 35-55 also hate being docs now in our current healthcare system. Being miserable about the current state of medicine doesn’t make docs automatically incompetent. But it doesn’t make for good doctors either when it comes to the all-important human aspects of medicine. I don’t think docs hide how they feel as well as they think they do.

          So, what are patients to do?

          • James O’Brien, M.D.

            Well, for one, stop being an ageist. Let me do the substitution for you since apparently you can’t go there, being in denial and all that. I’ll substitute “woman” for “doc over 55″ with other necessary contextual adjustments:

            “I’m not an sexist, but hearing how miserable and jaded many docs are, especially women, is making me consider whether I should avoid seeing docs who are women since so many of them apparently really hate being doctors and really don’t want to continue practicing medicine and would raise children if they could.

            My current favorite awesome doc is man. He seems old enough to have some solid experience, but he does not seem jaded or miserable practicing medicine (although, who knows? maybe he just hides it well). But I generally have good instincts about people and can tell when someone is genuinely unhappy. And I generally listen to and trust my instincts.

            Going forward in choosing any new docs I might need to see, I wonder if it would be wise to look for doctors who only men to increase my chances of avoiding docs who might be on their period and really hate being doctors at this point and are really not adjusting to our changing healthcare system.”

            I hate that I’m thinking this because, in general, I’m really not sexist.”

            I think you ought to spend less time worrying about correct attitudes and more time worrying about provider skill and competence.

          • Patient Kit

            I think you are (intentionally?) missing my point.

          • James O’Brien, M.D.

            I think you are unintentionally missing mine.

            Not a river in Egypt…

            Here’s some good advice. If you’re a cancer patient, go to the best oncologist you can find. Measured by outcomes, not by knowing winks and cuddles. His attitude toward changes in medicine is irrelevant to you. Do not look for kindred political spirits. If that excellent physician is not supportive enough, join a support group for patients.

          • Patient Kit

            I have no idea how my GYN oncologist feels about healthcare reform. Among the things I know about him are: He was willing to take me on as a patient when private practice docs wouldn’t. He performed serious major surgery on me with zero complications and an excellent outcome/prognosis. He treats me with respect and compassion and, even though he is a subspecialist, he sees me as a whole person. If I say I’m feeling fine physically, he asks me how I’m feeling emotionally, asks how I’m handling the stress in my life. He has offered to do what he can to try to help me stay covered by insurance while I’m doing freelance work and job hunting for a job with insurance. He is very thorough and answers all my questions patiently and in detail. He spent 20+ minutes talking to me on the phone midway between my 10-day and 3-mo post-op checkups.. He makes eye contact with me always. When I needed a CT before surgery in February, he suggested that I do it at an independent imaging facility not affiliated with his hospital because it was winter and would be easier on me to do it closer to home. He’s compassionate, communicative and an excellent surgeon. I don’t know or care what his politics are.

            I don’t buy that it’s fine for docs to have crappy personalities if they are good and competent at what they do technically. My doc has the whole package and that’s why I’ll recommend him to anyone. Seriously, I almost wish I’d get one of those much-lamented patient satisfaction surveys to fill out about him. [Note that I have no bias against male GYNs, a bias that certainly exists..] If we want to talk bias, I’m kind of tired of the bias here that private practice docs are somehow better than hospital-based docs.

          • James O’Brien, M.D.

            Thank you for that reasoned rebuttal. Because I was clearly recommending doctors who had flagrant personality disorders.

          • Patient Kit

            I don’t think I’ve ever seen a Kaiser P commercial, but I have seen plenty of NY Presbyterian commercials (the system I’m currently a patient in), so I know what you mean about those ads. ;-)

            Of course, first and foremost, I want my docs to be highly competent medically and have good outcome records (although not perfect because that would indicate that they don’t take on any difficult cases). That said, I hate to break it to you but I and many other patients do value what you call “that touchy feely nonsense”. I want both in a doc. I should also add about my compassionate doc that he’s very cautious about how many CTs he orders. I don’t know if he’s under pressure from hospital admin to order more but he doesn’t. And he makes eye contact and treats me like a whole person while not over-ordering CTs.

            It’s a given that we don’t want docs with severe personality disorders. But we also don’t want docs with cold, unfeeling, detached personalities. I think you undervalue “touchy feely”.

          • James O’Brien, M.D.

            I don’t and that’s why I suggested you seek therapy or support outside the doctor patient relationship. A competent doctor who is not a psychiatrist may be far too busy to deal with your emotional needs, which are clearly intense. So is the projection and denial. I know you don’t see the nastiness and bigotry in your post about older doctors and private practitioners.

          • Patient Kit

            Wow! Really? You feel competent to say that my emotional needs are “clearly intense”, based on this conversation? I don’t want my primary care doc or specialists to be my therapist. I just want them to be human — a concept that seems to make you very uncomfortable. I assure you that I’m not a particularly time-consuming, complex, demanding or needy patient. I’ve told my doc numerous times that I understand that all of his patients have cancer and that many of them are not as lucky as me (early stage). I am, by nobody’s standards, a difficult patient and I’ve repeatedly expressed my appreciation for all that he has done for me.

            Again, I don’t need or want my docs to be my therapists. I just don’t want them to be cold, detached, bitter and unfeeling. If you think wanting our docs to be human with us is unreasonable and needy, well, I don’t think I’m the one in denial here. Clearly, I pushed a couple of your buttons on age and private practice that you just can’t get past.

          • buzzkillerjsmith

            Avoiding docs with flagrant personality disorders?! That’ll leave, what, a half dozen?

            I myself am a malignant narcissist seasoned with just the right amount of antisocial. It works for me. My patients, on the other hand….

        • HJ

          With the cost of medical care and the risks associated with the wrong doctor, I reserve the right to be chose a doctor based on age, gender, nationality, race, culture, etc…

        • EmilyAnon

          “Guess what? You doth protest too loudly. You’re ageist. Substitute “African-American” for “55 and older” in your paragraph and see if it doesn’t read racist.”

          So you feel that no matter which doctor the patient chooses, (man, woman, old, young, black, white) their choice had to have been based on bigotry?
          Maybe to avoid aspersions, we should eliminate choice in favor of mandates. A young, black, friendly female patient will now be assigned to a grouchy, old, white, male doctor, and so on. That should level the playing field.

          • Patient Kit

            Hi Emily. This is the first time that a doc on KMD told me that I have intense emotional needs and I need a therapist. Actually, none of my docs in real life have said that to me either. Apparently, the idea of treating patients like they are whole people — not ovaries or tumors — is too much to ask. Apparently, it’s intensely needy and touchy feely nonsense to be human with each other. I swear, some days on KMD make me so grateful for how good my docs are. The bitterness here is palpable. Good thing I’m not as emotionally fragile as Dr O’Brien thinks I am.

          • EmilyAnon

            Well, he’s a psychiatrist, so he sees a personality disorder in anybody who challenges him. You emotionally fragile? Definitely not.

          • Patient Kit

            Dr O’Brien is a psychiatrist? I didn’t know that. I was wondering what field of medicine he practices in that has him so hellbent against the concept of doctors treating patients like they are whole people. Like oncologists shouldn’t care about their patients emotional well-being! Okey dokey, then. He came up with a pretty extreme assessment of me, based on very little. I wonder if Dr O’Brien accepts Medicaid or Blue Cross or any insurance. LOL! You just made my day, Emily. I guess I should have guessed from his overuse of the word “denial” and especially by the mention of that river in Egypt. LOL! at a psychiatrist being so against “touchy feely nonsense”. :-D

          • James O’Brien, M.D.

            Please point out where I said anyone had a personality disorder. I pointed out neediness and bigotry and denial and projection of a lot of internal hostility. You can infer from that what ever you want but I did not diagnose a personality disorder.

            If you choose not to have an older doc, or a doc of any ethnicity or a woman because they are incompetent, that is smart. If you choose to not pick a doc because of ignorant stereotypes, that is bigotry and idiotic. I couldn’t have possibly been more clear about that. And of course I never came up with your crazy straw man of assigning patients to doctors they don’t like.

            I also never discounted the importance of bedside manner or the feelings of the patient. I said it wasn’t as important as clinical skill. In what universe does this mean I am against the patient’s emotional well being?

            These posts are becoming increasingly brain dead and some are bordering on libel.

          • EmilyAnon

            I’m at a loss how to respond to your overreaction, so I won’t.

          • EmilyAnon

            Well, my loss for words didn’t last long because I just came across a wise saying you posted on another thread:

            “As a general rule everyone should stop scouring the earth looking for reasons to be offended.”

      • Suzi Q 38

        My doctor is about 60 or 62.
        He has been my doctor for over 12 years.
        I am hoping he survives the next decade, if I do.

    • Suzi Q 38

      “….1) Divorce (workaholic syndrome)
      2) Support of young children (starting families late)…”

      Yes, I agree. Also, if the divorce moves to a remarriage with a new spouse and additional children, there is more money that has to be earned to pay for all of this.
      My ex sister in law was awarded $6K a month for about 20 years for my brother’s 4 children, and he wasn’t a doctor.
      He also had to sign over 2 paid off houses in the divorce, as he wanted to keep his business for himself.
      He then married again to a new trophy wife who was very expensive to maintain….they had a child, then divorced, and he lost $$$$ again. She got their house plus short term spousal support and child support for their daughter until she was 18. My brother also put all 5 children through a state college of their choice, plus room and board.

      Luckily, he is resourceful and continues to thrive financially.
      I just told him not to marry again, as he doesn’t do well in that department, or he will lose $$$again.

      He definitely makes more per year than most doctors.

  • Curtiss Mull M.D.

    For you, maybe the division to retire was the right one. Just don’t try to make it right for all physicians. At 62, a physician should be at his most effective time ,both as a diagnostician and a surgeon. When I semi retired at 62 , it was because it was consuming too much of my life. Thus for me, Locums was the way to go as it gave me freedom,,but allowed me to provide quality care unrestrained from politics or financial needs. At 74 I continue to work on my own schedule, comfortable in the knowledge that my associates will let me know if my work is less that of the highest quality. I know that if I feel uncomfortable in any surgical situation, I will quit the next day. At the hospitals where I work, I have to credentialed every year, which is understandable. We all know of cases where incompetence was tolerated too long, even in relatively young physicians. Am I as good a surgeon as I was at 60? No, but I have taken that into account by restricting the cases I do. There is no right or wrong answer as to when to stop practicing medicine, as each of us have to decide how our senior years will be spent. The beauty of our profession is that we can make that decision in many different ways

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