Like a breeze rippling across a lake, the end of your career is approaching and you cannot escape its path. You can see it coming, and before you know it the inexorable movement will rush past you. You have two choices: Build a sail so that you can capture the energy and move with it, or remain unprepared and be left behind as it sweeps by.
The trick is to seamlessly move from full-time practice to the next chapter in your life, while fulfilling your philosophical, physical, and emotional goals and going to your strengths. It is an enormous waste of wisdom for doctors who have gathered decades of knowledge and experience to simply walk away from medicine. It is actually a public health disaster. For the first 30 to 40 years of your life, you were educated to care for the public, and the payoff for society was an equal number of years of service. However, if there are opportunities for the doctor to continue to give back to society for another 10 years, that payoff increases by 25%.
Planning for Transition
Every physician knows that a professional career must come to an end. Some hang on longer than is safe for them or their patients. They hang on because of the fear of the future. There is an art but also honor and grace in just letting go. However, with planning—which should start years if not decades before the inevitable transition—the plans become a natural extension of life rather than an abruption of it.
In my particular situation, I became involved with national politics 20 years before my forced retirement. I planned for a seamless shift from urology private practice and public policy to consulting exclusively in public health policy. I did not know at the time that I would be forced to retire early due to the ravages of malignancies and their complications, but I was ready. I built my sail for the oncoming winds of change and was able to take advantage of even the unexpected dire circumstances. I am recommending the same to you.
The Value of Teaching
Teaching has always been a responsibility of physicians. Whether we teach our patients or teach students and/or residents, we fulfill our oath and satisfy an inner longing to pass our knowledge, experience, judgment, and wisdom to those who follow us. This is our duty to ourselves, our teachers, and the patients who will be treated in the future. As in the Hippocratic oath we swore upon receiving our medical degree:
I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement: To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art [italics added].
There is a medical school, a teaching Veterans Administration hospital, or a community clinic (federally qualified or not) within 50 miles of almost all physicians. It is very satisfying to teach and care for those who are underinsured or uninsured, whether for compensation or as a volunteer. It is a graceful and dignified exit from a career that has been the pride of your professional life.
There are also financially productive and professionally adventurous routes by which to expand your horizons just as your practicing medical professional career is in its denouement. The knowledge and experience that is gained during the 30 to 40 years of practice allows you to effortlessly provide value to businesses that engage in the health industry. Since 16% of the American economy is derived from health care, the opportunities are vast.
Decisions that would take weeks of focus by the uninitiated, nonphysician executive would have immediate clarity to an experienced physician. Furthermore, there is a greater chance that you—as opposed to the nonphysician businessman—would make the correct decision based on your judgment. That is why so many businesses understand the value of physician executives. The doctor needs to recognize his/her strengths in this context as well and provide a compelling argument to prospective employers.
Your responsibility to yourself and family is to build a sail that is ready to take you to the next chapter of your life. Get ready; the wind is coming your way. ■
Disclosure: Dr. Boxer reported no potential conflicts of interest.
Dr. Boxer is Professor of Clinical Urology at the University of Miami and Clinical Professor at the University of Wisconsin, Madison, and the Medical College of Wisconsin.