American Association for Physician Leadership

Retirement — Hanging Up the Stethoscope

Neil Baum, MD


David F. Mobley, MD


Nov 1, 2022


Volume 9, Issue 6, Pages 60-61


https://doi.org/10.55834/plj.3815712930


Abstract

Physicians are well-educated in diagnosing and treating medical conditions but receive no guidance on how to exit the practice of medicine. As a result, few of us know when to leave the umbrella or the cocoon of healthcare. Even worse, we have no guidelines on what to do once we hang up the stethoscope and take down the shingle and how to go from working 60 hours a week to zero with nothing to fill the days.




Historically, physicians are famous or infamous for their lack of business acumen. Many medical schools are remedying this situation by incorporating business basics in medical education. Also, many American medical schools now offer combined MD/MBA degrees.

Physicians are well-educated in diagnosing and treating medical conditions but receive no guidance on how to exit the practice of medicine. As a result, few of us know when to leave the umbrella or the cocoon of healthcare. Even worse, we have no guidelines on what to do once we hang up the stethoscope and take down the shingle and how to go from working 60 hours a week to zero with nothing to fill the days.

Unless you fall dead at work, you will retire. The decision to retire can be forced, filled with concerns and anxiety, and challenging. Or in the best-case scenario, the process can be easy and enjoyable.

Some retirements of non-physicians, such as pilots, are age-related. Other careers have a typical timeline; most military personnel retire after 20 years of service. Some professions and occupations offer full retirement benefits after 20 or 30 years of employment, and workers aim for those dates from early in their careers.

Reasons Doctors Retire — And Don’t

Many physicians are self-employed or employed as part of a large physician organization or academic center. Regardless of their employment status, the decision to retire, including when and how, often rests with the physician — a personal choice made without outside pressures.

Physicians who retire early commonly cite health concerns and loss of professional autonomy, along with issues associated with psychological stress and burnout. Physicians’ reasons for delaying retirement include respect for their patients, a lack of interests outside medicine, inadequate financial readiness, and a fear of losing their sense of identity.

When considering retirement, physicians often must balance two concerns:

  1. They enjoy being in practice and don’t want to retire too early. Being a physician is often at the core of who they are, and they worry about how they will feel without the work and the status that accompanies their work.

  2. They don’t want to wait too long because poor health — theirs or their partner’s — may prevent them from enjoying the last phase of their life. Most physicians want to retire while still healthy and able to enjoy physical activities such as travel.

In addition, physicians may wrestle with issues of identity, status, wellbeing, and relationships. Because being a physician is often at the core of who we are, we worry about how we will feel without the work and the status it affords. Our patients and their families express how appreciative they are of our care, and when we retire, the lack of appreciation and recognition may create a void we must find a way to fill.

Physicians report losing interactions with colleagues and patients as one of the significant deficits of leaving the practice of medicine; a concomitant loss of purpose, feelings of boredom/loneliness, and even depression are top concerns of retirees.

Making the Decision

Physicians’ careers revolve around making decisions about their patients’ healthcare; however, doctors may struggle to decide when to retire. When they make that decision freely, it is based to some degree on whether the physician will have enough money to retire comfortably. If that metric is not met, retirement is not likely anytime soon.

Once the financial metric is met, myriad other considerations come into play. Perhaps the most important question becomes, “Do I want to quit working?” As discussed earlier, there are many benefits to being a physician, including status and passion for the work. How many jobs can you work every day with the sole mission of improving someone’s quality of life?

What about all the medical knowledge physicians possess? As doctors reach retirement age with years of accumulated knowledge, and having been exposed to every possible situation, diagnosis, and complication within their specialty, they hope they can continue to use that learning — and they can, if they make plans for an active retirement.

Bottom Line

The transition to retirement can be daunting, but with planning, can be successful. When physicians leave the security of the medical practice and give up a regular job, money, and prestige, they may go through a grieving process. However, physicians who have a retirement action plan in place and execute that plan report that retirement is delightful and rewarding.

Neil Baum, MD

Neil Baum, MD, is a professor of clinical urology at Tulane Medical School, New Orleans, Louisiana.


David F. Mobley, MD

David F. Mobley, MD, is a practicing urologist in Houston, Texas. He is an associate professor of urology at Weill-Cornell Medicine.

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