The Physician’s Retirement

Posted Jan 31, 2020

Merville Vincent

Editor’s note: This is a condensed version of an address Dr. Vincent gave to the Ontario Medical Association Scientific Session May 12, 1977. The issues addressed are as pertinent today as then. Dr. Vincent, a long time member of CMDA Canada, has had a life long interest in issues of physician well-being which has very recently been discovered as an issue by the profession at large. – W James Fenton MD FRCPC

I would like to define retirement not as resigning from life‭, ‬but as that period of life when you are free to do things you want‭ ‬to do‭. ‬This may even be practicing medicine with greater freedom‭. ‬

If a number of current trends persist‭, ‬I believe that we shall see an increase in the number of physicians retiring‭. ‬Some of these trends are‭:‬

Malpractice insurance is becoming more expensive‭. ‬This may make slowing down a practice less affordable‭.‬

More physicians are in salaried positions or group practices‭. ‬These positions often produce pressure to retire as well as providing pensions that make it practical‭.‬

It is increasingly difficult to keep up with the technical advances of medicine‭.‬

Peer review is here‭. ‬Added to this is the need to document learning‭.‬

Perhaps physicians have always grumbled‭, ‬but it is my impression that I hear physicians increasingly express their disenchantment with medical practice‭, ‬saying that they are getting tired of red-tape‭, ‬filling out forms‭, ‬seeing their autonomy disappearing‭, ‬all while the risk of being sued increases‭.‬

The Physician’s Fear of Retirement

People do not look forward to retirement‭, ‬and physicians share this view‭. ‬Most of us are prepared to admit that we do not like the idea of getting older‭. ‬We accept growing older because there is only one alternative‭! ‬In not wanting to grow older‭, ‬we often‭ ‬avoid sensible planning for it‭. ‬Physicians tend to share the public’s negative view of retirement that sees retirement as a very stressful transition‭, ‬often followed by serious maladjustment‭, ‬physical and emotional deterioration‭, ‬decreased life satisfaction and expectancy‭.‬

However‭, ‬studies in recent years point in a more positive direction‭. ‬Poor health is much more commonly a cause of retirement than as a consequence of retirement‭. ‬Studies suggest that retirement improves physical health and do not confirm that retirement brings about a decrease in‭ ‬“general life satisfaction”‭.‬

The most important variable in adjustment to retirement is not retirement itself‭, ‬but rather the individual personality and life‭-‬patterns of the individual‭. ‬Further‭, ‬these are cultivated early in life and are not subject to change suddenly at the moment of‭ ‬retirement‭.‬

A recently retired physician considering reasons offered for not retiring‭, ‬wrote‭:  ‬“the really important reason that doctors are loath to admit‭, ‬is that they know little and can do little outside of their own little worlds‭. ‬Doctors as a class are very poorly educated except in medicine‭.‬”

Dr‭. ‬A‭. ‬D Kelly‭ (‬General Secretary of the CMA from 1954‭ ‬to 1966‭) ‬said‭: ‬“We have been accustomed to hard‭, ‬responsible work for long hours and most of us have been so immersed in professional activities‭, ‬that avocations have been neglected”‭.‬

The Basis of a Satisfying Retirement

A philosophy of life or belief-system is needed that permits you to see yourself as valuable‭, ‬gives you self-esteem and a sense‭ ‬of identity which is not based solely on your work output or production‭. ‬If our self-esteem is based solely on our productivity‭ ‬both are likely to decline with the years‭. ‬To be useful‭, ‬our philosophy and faith must help us live with the inevitable losses of advancing years‭.‬

Good physical health certainly adds satisfaction at all ages‭. ‬Much ill-health results from‭ ‬“diseases of choice”‭ ‬and should I add‭ ‬“procrastination”‭? ‬Tomorrow I start my diet/exercise/quit smoking‭, ‬etc‭.‬

A positive attitude towards retirement is also vital‭. ‬A healthy attitude views retirement‭, ‬not as a crisis event‭, ‬but rather as‭ ‬one of life’s expected transitions‭. ‬Retirement is best looked upon as the beginning of a new career‭.‬

Dr‭. ‬Wilder Penfield advises‭: ‬“When a man reaches his 60s‭, ‬he should be released from heavy harness‭ […] ‬given the opportunity of starting a new or modified career‭. ‬The nature of that career must depend on interest and ability‭. ‬It should provide greater latitude of living‭, ‬allowing a variable or decreasing amount of physical labour‭. ‬To most men there should come a time of shifting harness‭, ‬for lightening the load one way and adjusting it for greater effort in another‭ […] ‬time for the old dog to perform new tricks‭. ‬The new career may bring little or no money‭; ‬it may be concerned only with good works‭, ‬it may‭, ‬on the other hand bring in support that is much needed‭. ‬It can be a delight to a man‭, ‬who comes at last to a well earned job instead of a well earned rest‭. ‬It can be too‭, ‬what society needs most from him‭.‬”

I am suggesting we should all plan for the possibility of retirement‭. ‬The sooner we begin to plan the better‭ ‬‮–‬‭ ‬like today‭. ‬Life‭ ‬is unpredictable and full of the unexpected‭. ‬If you plan‭, ‬you must be prepared to modify your plans‭.‬

Assuming a satisfying philosophy of life‭, ‬reasonable health‭, ‬finances‭, ‬and a positive attitude‭, ‬what next‭?‬

Start now to notice things having to do with retirement‭. ‬How do you wish to spend your time in retirement‭? ‬What are the activities you enjoy‭? ‬Make a list of interests and activities that you would like to develop‭, ‬but don’t have time for now‭. ‬Try out some of these ideas‭. ‬Seek to develop or maintain non-medical interest throughout your life‭.‬

As the years go by‭, ‬try to make time to develop these interests‭, ‬hobbies‭, ‬avocations or skills‭.‬

If possible‭, ‬ease into your second career by progressively arranging more leisure time to try out the things you think you are interested in‭.‬

Don’t forget to cultivate your marriage relationship‭. ‬It grows best if looked after‭. ‬Include your spouse in your retirement planning‭. ‬If you are married‭, ‬satisfaction in retirement is closely related to marital satisfaction‭.‬

Consider where you wish to live‭. ‬A word of caution‭: ‬before a radical move‭, ‬try it on a temporary basis‭ ‬‮–‬‭ ‬don’t burn your bridges prematurely‭.‬

Most physicians need some challenge to use their talents‭  ‬through out their life whether that be in formally paid work or in a variety of forms of unpaid service‭.. ‬Many forms of volunteer work are available that can make use of a physician’s knowledge and experience‭. ‬Adult education can also challenge and interest the retired physician‭.‬

What are your plans doctor‭? ‬