“I had the advantage of being in an academic environment, which I think gives you more options,” said Dr. Greenfield, who is also editor-in-chief of SURGERY NEWS, the official newspaper of the American College of Surgeons. “I had a long list of things I thought I might want to do related to hobby activities, like photography and other kinds of creative writing, but I'm too busy for that. I have too much to do.”
Dr. Greenfield describes successful retirement as a three-legged stool:
▸ The first leg: good health and financial security. Good physical health is a given, but it's also important to be in good financial shape.
“Most people I know have their [financial] ducks in a row, but I am sure there are a number of people who don't,” said Arthur J. Donovan, M.D., a retired general surgeon who lives in Pasadena, Calif.
“Some physicians will retire with a fixed-benefit retirement,” said Dr. Donovan, who retired from the University of Southern California with emeritus status in 1990. “They also will almost invariably have deferred compensation. They're going to have IRAs [individual retirement accounts] or Keogh plans that they put money into, or they're going to have 401Ks. There are a lot of options in how you use that money, but you need to get some good advice on that. Talk to a tax attorney or a financial planner who knows the tax implications.”
Dr. Barnett said that she socks away as much money as she can each year into her SEP-IRA—a simplified employee pension plan for the self-employed—and that she chooses to live frugally, “so I'm probably ahead of the game in terms of being able to retire. I paid for my medical education by going into the military, so I didn't come out with big debt. I've never had the fortune to have a family,” she added, “and at this point, it's unlikely that I will have one, so there are no kids that I have to put through college. I could retire and live comfortably tomorrow if I wanted.”
As a resource for smart financial planning, Dr. Greenfield recommends reading “The Four Pillars of Investing: Lessons for Building a Winning Portfolio” and “The Intelligent Asset Allocator: How to Build Your Portfolio to Maximize Returns and Minimize Risk,” both by Dr. William J. Bernstein.
▸ The second leg: family. “Because you have a new relationship within the family, you will have probably more household responsibilities, and I think that's appropriate,” Dr. Greenfield said.
▸ The third leg: a worthwhile activity. This could mean pursuing a hobby or an artistic endeavor, “just something that gives you a reason to look forward,” Dr. Greenfield said.
For her part, Dr. Barnett does belly dancing, specializing in East Indian, Indonesian, and Polynesian sacred temple dances. In retirement, “I could conceivably fill my time with the dance world, either teaching or performing,” she said.
Kurt Mosley, vice president of business development for Merritt, Hawkins & Associates, a national physician recruitment firm, said that most retiring physicians he has known could benefit from a hobby outside of clinical medicine, because they wind up missing the daily contact with patients.
“Many doctors who retire say, 'I'm ready to get out of the rat race,' but they volunteer once a week at an Indian reservation or they do work in a nursing home, just so they're not sitting around,” he said. “They have to have something to do, or the doctors tend to wither away. I think MacArthur said, 'Old soldiers never die; they just fade away.'”
Dr. Marguerite P. Barnett, who enjoys belly dancing, is not yet retired—but thinks about it. David Gittens
Patient Care: Older Physicians Want Out
In 2004, a national survey of 436 physicians aged 50–65 years conducted by the physician recruitment firm Merritt, Hawkins & Associates revealed that only 8% plan to retire in the next 1–3 years.
However, 51% of the survey respondents indicated that they plan to make changes in the next 1–3 years that will take them out of the patient care setting or reduce the number of patients they see. This sentiment was strongest among physicians aged 50–55 years and those aged 56–60 years. Most of those aged 61–65 years indicated that they plan to continue practicing as they are.
General dissatisfaction with medicine was listed as the primary reason physicians intend to shift away from or reduce their clinical workload, followed by rising malpractice insurance rates.
“A lot of them are saying, 'I want to wind down my practice, and I want another career, maybe in research,'” said Kurt Mosley, vice president of business development for Merritt, Hawkins. “A lot of the younger old—the 50- to 60-year-olds—are teaching. We can't really create more medical schools, but we need more facultyto train these newer physicians.”