Thinking About Retirement? Read This First

Job loss consistently places among the top five most stressful life events. And if you think about it, retirement is essentially a job loss—you’re just doing it on purpose instead of being dismissed. And though retirement is supposed to be relaxing (all that free time!), some folks find that it’s not exactly as they envisioned. This is especially true of those, like physicians, who’ve left behind mentally-stimulating, highly respected careers. They miss the camaraderie, they miss a sense of purpose, and most of all they miss using their brains.

So it’s understandable if you’re not ready to make that big life change. You rather wade into retirement than dive in head first. You want some of the benefits of retirement, but still enjoy treating patients. It may be time to consider partial retirement. But if you think it’s as easy as informing your partners and telling your receptionist “Hey, I’m only taking appointments three days a week now,” think again.

“Easing into retirement can take longer than you think,” says Paul Orloff, MD, who spoke about partial retirement at AAO 2017. You “need to plan ahead emotionally, financially [and] intellectually,” he says.  It’s “obvious but essential … and hard.” Here, we give you a plan to extend your time practicing medicine, while still reaping the benefits of your golden years.

Partial Retirement: What Is It?

Partial retirement means something different to everyone:

  • If you’re a high-volume surgeon, you can do fewer cases.
  • You can stop major surgeries, but still perform minor, office-based procedures.
    • Tip: Your malpractice insurance can give you guidance as to what is allowed for a given coverage level.
  • You could stop surgery entirely, and focus on medical ophthalmology (dry eye!)
  • You might stop accepting insurance. You’ll see fewer patients but it won’t affect your income much.
  • You could work part time, either fewer days per week, or shorter days.

The big question about partial retirement is usually when to stop surgery—and that’s a major decision, says Harry Zink, MD, who sat on a panel at AAO 2017’s Senior Ophthalmologist Symposium. Surgeons, well, surgeons love surgery. Eighty percent of “our” conversations are really about surgery, even though it’s really about 20 percent of “our” workday, explains Zink. And nowadays, everyone is practicing longer. Most don’t completely give up surgery right away.

“Life on the bench was not as much fun” –Harry Zink, MD, on sitting out surgeries

The reasons for stopping are many, according to Zink. Those reasons may include:

  • Physical issues like tremors or numbness in hands/arms
  • Cognitive issues like lapses in attention
  • Your skill level has reached a plateau. As new technologies emerge, you feel behind—and you don’t really want to catch up.
  • Stress avoidance
  • The changing reality of practicing medicine. You feel like you’re “treading water.”
  • Wanting more time for travel, family, and outside interests.

Everyone has their own reasons and decision making process. There are definitely good reasons for slowing down, but there are no bad ones. Go with your gut.

Myth: You need to stop for malpractice reasons.

Fact: Older surgeons have lower malpractice rates and lower settlements. “Even if cognition is going down, our judgment is better,” says Zink. It’s proven that your malpractice risk is lower at age 60, he points out.

“Father Time is undefeated.”

 Who’s Next?

If you’re a solo provider, finding someone to buy your practice can be a challenge. One reason? There’s a shortage of ophthalmologists entering the field. “We take a long time to train and we are very expensive to train,” says another AAO 2017 panel member, Samuel Masket, MD. Ophthalmologists are retiring at a faster rate than are entering the market.

And when you do find someone to take over, it will probably be (gasp!) a Millennial. The perspective of these young physicians, who are mostly in their mid-to-late thirties, can be confusing to retirement-aged ophthalmologists, who tend to be early baby boomers.

Some older physicians feel that younger associates don’t want to “pay their dues” as an entrepreneur. They don’t want to become owners, but they expect owner-level pay. “The Millennials are different from what we were,” said one panel attendee. And they are—Millennials have lived through the great recession, a couple of wars, and a lot of uncertainty. That means that, for them, stability is top of mind They want the high pay and job security right away.

But if you want to get the buy-ins, you have to meet the market, says Zink. People go into ophthalmology in part for the quality of life. They want to go home at 4:00. And they don’t want the risk associated with starting up their own practice, or owning part of a group practice. But that mindset doesn’t come without caveats, points out Derek Preece, MBA, another panel member. “We are seeing private equity groups buying up practices. Over time there will be consolidation and non-physician ownership of practices. The Millennials who don’t want to buy in now simply won’t make as much money over the course of their careers,” he says.

What’s Next?

“Ophthalmology is replete with people who have gone on to second careers,” according to Susan Day, MD, who also presented with the AAO panel.  A few interesting examples?

  • Rand Paul (U.S. Senator, Kentucky)
  • Sir Arthur Conan Doyle (author and creator of Sherlock Holmes)
  • Howard Schatz, MD (acclaimed photographer with 20 published books)
  • Robin Cook (New York Times bestselling author)

If you’re looking for rest and relaxation, now might not be the best time to get into politics. And you might not have an idea for a Pulitzer Prize-winning novel. But the point is this: there is life after practicing medicine. A good portion of near-retirees want to do something different at the end of their career. There is a thirst to learn, emphasizes Day. And she should know. Day, a past president of AAO, now works at the Accreditation Council for Graduate Medical Education.

So before you start the retirement process, spend some time thinking about how you’ll fill your time. Traditional retirement activities may seem great at first but “can quickly wear thin,” Orloff notes.

Continue to work in medicine in some form, he recommends. Here are a few other non-patient roles to take on in partial or full retirement that would benefit from your experience:

  • Writing
  • Research
  • Student teaching,
  • Attending/speaking at conferences and seminars
  • Taking courses at a local college.
  • Medical malpractice consultant
  • Community outreach
  • Expert witness
  • Bureaucrat for MedicarE

In our next post, we’ll get into the logistics of how to make partial retirement work for you.

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