What Shall I Retire To?

The other day one of the residents sent me this link, which he thought I might enjoy. I replied that I’d seen it before and actually posted about it shortly after it had been published.

The residents know I have “causes” on which I spend a fair amount of energy and the Maintenance of Certification is one of them. However, I’ve used the word “retirement” a lot recently. Those causes are the reasons I want to retire.

My wife is a regular reader of Vanguard Bogleheads and mentioned a couple of threads she thought I’d be interested in. The first thread was started by a physician who is thinking of retiring and he wrote:

“Are there any boglehead physicians who are tired of the current medical practice and ready to give it up? I have been practicing solo for 20 years. Although I love the patient care itself, I am increasingly frustrated about the side shows which come with practice of medicine. Sometimes I feel like retiring early. Does anyone feel the same way?”

This struck a familiar cord. The original poster never replied to the many comments on the thread. The moderator finally closed it because she thought it might be causing more distress than necessary. There were a lot of rants about how stressful it is to practice medicine these days.

I read several rants with which I identified. However, not all the comments were negative as you can read for yourselves. A few excerpts are worth repeating:

Seems a BH MD vent thread recurs every 1-2 months or so – with most replies being: take vaca/retire, change jobs/practices/concierge, medical mission, get outside hobbies/interests. During my internship, a Chief told us that if we weren’t happy, our expectations weren’t meeting our reality. And we could either improve our reality, or modify our expectations. Blunt and true.

I think the vast majority of the woe is me is coming from middle aged to older physicians that feel the rules have changed on them and they are having to deal with an ever increasing regulatory, insurance and paperwork burden with stagnant pay and potential more hours. No matter the profession people at this phase always feel and bemoan the good ole days. My father did the same as a pharmacist. He retired because of just those things. He also states, just as many older physicians do, that he would no longer suggest young people go into pharmacy. What most of these folks do not get is that this regulatory and paperwork burden has drastically increased across most industries. That for young people just starting out this is all they know, so they are not burdened with the mental anguish of wishing for those good ole days. They see know the current job, the current pay and the current work hours as their baseline which in total are all drastic upgrades from their prior residency pay.

And there was one the moderator probably preferred because it was generally uplifting, hopeful, and possibly helpful to the original poster:

Sounds like I may be in the minority, but I’m a physician who is neither burnt out or jaded with the profession.

Things I have found helpful (and some advice for medical students/residents/young physicians):
1. Being young. Older docs complain endlessly about how the profession has changed for the worse. As a younger doc, I have no knowledge of how easy or lucrative medicine used to be, and that ignorance is helpful. Obviously not something you have any control over, but my experience is that younger docs are generally much happier than older docs.
2. Choosing the right field for the right reason. Hate interacting with patients? Maybe radiology/pathology/anesthesiology is for you. Hate being rushed or stressed? Avoid OB, EM or ICU. I spent the 4th year of medical school doing acting internships in the 3 different fields I considered going into, and that was time well-spent to help me make the right choice. Same thing applies before applying for fellowship training. Those who chose fields for prestige or income or lifestyle are often unhappy with their job.
3. Having the right colleagues and not hesitating to leave if you cannot get along with your colleagues. Some physicians spend more time with their colleagues at work than their families at home.
4. Focusing on the positives of the job. I keep thank you cards and pictures of my patients on my walls. Negative reviews and lawsuit paperwork go in a file cabinet only to see the light of day when needed. Talk about the positive patient encounters when you go home to your family, not the negative ones.
5. Willingness to create change. My colleagues complained endlessly about specific aspects of the EMR, but did nothing about it. I made a lot of phone calls, figured out who could fix the problem, had them work with the vendor, and got some changes made in a few weeks. How quickly something gets fixed is completely independent of how much you complain about it unless you complain to the right people who can change things (i.e., usually not your colleagues).
6. Willingness to go part time or quit anytime. I live well below my means, paid off my loans ASAP and socked away a stash of FU money. I constantly look at job boards and locum opportunities, even though I’m happy with my current job, so there will be less job-search stress if my current job suddenly takes a turn for the worse. I network with colleagues from residency, fellowship and prior jobs to keep abreast of opportunities that may not be posted.
7. Not forgetting the crappy jobs I’ve had in the past. Compared to residency (pre-80 hour work week, I estimated I was earning about ~8/hr), this is easy money.
8. Do not be involved in any committees or any aspect of administration, if you can avoid it. Do not be tempted by the “honor” of being asked by your department chair to be part of a committee. Do not disillusion yourself into thinking that committee work will help you “climb the ladder”. Do not believe for one minute that committee work will “make things better”. In my experience, administrative/committee work is unpaid, generally unproductive, frustrating, additional work that generates no revenue and takes time away from patient care, your family and hobbies. 

If my children wanted to be physicians for the right reasons, I would not discourage them.

And then there was the other thread about retirement which also made me reflect about my own plans. The main theme here seemed to center eventually on settling whether one is retiring from something or to something.

I think that’s what I secretly fear–that I’ll not have anything purposeful or engaging to do when I retire, and even that the threat of retiring is just another rant about what I don’t like about my profession. I got to thinking about a blogger whose site I haven’t visited in a long while. It’s still there, retireediary The Diary of a Retiree. I think his photographs are beautiful and I’m so glad Michael Lai shares them with us.

So now I’m beginning to think about retiring to something rather than from something.

2 thoughts on “What Shall I Retire To?

  1. “1. Being young. Older docs complain endlessly about how the profession has changed for the worse. As a younger doc, I have no knowledge of how easy or lucrative medicine used to be, and that ignorance is helpful. Obviously not something you have any control over, but my experience is that younger docs are generally much happier than older docs…”

    Sounds like ageism to me Jim.

    It may be one of the reasons that physicians are so politically ineffective. Instead of recognizing that there is a real problem when MBAs take over your field – stay blissfully ignorant and make sure you have a suitcase full of FU money. Yeah this guy doesn’t sound burnt out to me!

    I don’t think I have heard any complaints about how “easy or lucrative” medicine used to be. Only that we used to be allowed to practice medicine. If young physicians don’t get that then they are a sorry lot.

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