I read or write about early retirement on a more or less continual basis. Most of the news is positive, although it’s not uncommon for people, particularly physicians, to fail their first go at retirement.
After reading the thread he started on the WCI Forum and the article he sent, I still had more questions. He answers them in the brief interview that follows.
I’ll close out today’s intriguing collection with a little more information from the DocNextDoor, including his recommendations for someone else with a primary care income who may eventually want to check out of medicine before reaching a typical retirement age.
Be careful if you do. The reaction to your good news may not be what you expect. The following is from the anonymous primary care physician DocNextDoor.
Physician Retires Early and is Met With Scorn
We have all had to deliver some form of bad news to patients and I am no exception. Whether it be informing parents they have lost their unborn child, discussing end-stage kidney, heart or lung disease and needing to determine end-of-life care or notifying a patient of their diagnosis of a terminal condition such as metastatic pancreatic cancer or an incurable neurologic disease.
It is a conversation I have had many times throughout my career and I have been as caring as possible to my patients. It is always emotional and I am there for them in their time of need as tears are sometimes shed.
The news I have been delivering to my patients over the past year, however, has sparked their emotions most of all.
“I am retiring.”
That statement has resulted in an outpouring of tears from men, women, young and old. I have been on the receiving end of a full emotional spectrum before my last steps out the door. Together, we have experienced stages of grief over this event.
Learn how to better manage your student loan debt, and explore refinancing to a lower rate with cash back offers up to $1,000!
You’re Too Young to Retire!
There have been those in denial, with of course, the ubiquitous “You are too young to retire!” as at 51, I am years away from the typical retirement age for doctors, especially primary care. Some are insisting I will be back at work in a few months or that I am about to show up at another office down the street and they will be calling for an appointment when they see the announcement in the paper (that is not happening).
Amongst the emotions, what has surprised me the most has been the anger. Statements that sting are those such as: “I hate you,” or “Does everyone hate you as much as me?” “You don’t care about me,” “You’re mean,” “You’re selfish,” and “The nerve of you!”
Patients have spoken these words directly to me with no hesitation and with force.
Many patients have bargained with me “You only see me once every 6 months, so you only have to work 2 days a year.” “If they pay you more will you stay?” “Can you do house calls?” Or “Could you see me out of your garage?”
Some patients emphasized the financial aspect with statements such as “Well you must be a millionaire.” “Have you really thought this through?” Or “You must be paid too much.”
There have been depressive comments including “That is awful,” “You are just going to let me die,” “What will I do without you?” “Worse than me being sick,” “Horrible news,” and “I’m going to stop all my medications!”
One of my favorites was a husband and wife who came in for physicals in different rooms, after seeing the wife and her being very understanding of my retirement, I entered the husband’s exam room. Upon telling him the news he states “It would have been better if my wife told me she was leaving me.”
Burnout and Grieving
I guess I have gone through some grieving as well due to my admitted burnout and planned exit from my practice.
I announced my intention to retire and submitted paperwork about a year ago. Initially, in some denial, I did not want to tell some of the patients, acting as if everything were the status quo.
Anger would sometimes set in during some days, I would catch myself speaking out, mad at the healthcare system, mad at the insurance companies, mad about another form to fill out and document.
The anger would sometimes fade into melancholy, another 13 hour work day with no lunch and no time to exercise or to spend time with family. Work/sleep/work/sleep and repeat, spinning on the hamster wheel; it seemed like old times in residency.
I had cut back my clinic hours to try to reduce the stress and burnout, but it continued. I bargained to myself if only my organization would have let me stop taking additional new patients, unassigned hospital discharge patients and emergency room follow-up patients without primary care physicians, maybe I would have stayed (maybe not).
I am now to the point of acceptance. I have enough and I’ve had enough. With my final days winding down I no longer worry about the comments. I will get through to the end by working days off and weekends to provide the best care possible, if that is what is needed.
I no longer try to explain my situation or attempt to go into details about how I will spend all of my available time. My patients also have started to come around with congratulations and cards. It may have been the worst news ever for some but many patients now comment on how happy they are for me and well wishes for whatever I may do in the future.
[PoF: Those are some strong reactions. No, not strong. Vile! I imagine the reactions speak to the relationships you had built over time with your patients. It’s as though you’re breaking up with them out of the blue and they didn’t even see it coming.
As an anesthesiologist, I won’t have to worry about any of this negativity being cast in my direction. My last patient won’t have a clue that I’m minutes away from leaving medicine, and I prefer it that way.
Thank you for sharing your experience. It gives our primary care doctors and specialists who have longstanding relationships with patients something to ponder as they contemplate exiting the workforce on their own terms.]
Question and Answer Time
When was your last day?
I finished at the end of the third quarter 2018, that’s September 28th. The downside of my particular timing is that I was not eligible for any end of the year quality and patient satisfaction bonuses. I could have worked another 3 months but it’s only money.
Have any of your physician colleagues had similar reactions as your patients?
My physician colleagues have all been positive including the specialists that are aware that I am retiring. Some saying they wish they could do the same. I do feel for my coworkers who will need to take on the burden of additional patient load and hope that I am not the impetus for anyone else’s departure if they are not yet ready.
What are your short-term and long-term plans after retiring?
My short-term plans after retiring will initially be to take a breather from the hectic workday. I think I will enjoy dispensing of the frequent logging on to the EMR whittling down the inbox only to see it erupt with additional messages. Maybe I’ll learn about these things called Facebook and Instagram that I hear people talk about.
I have always been DIY, which has helped with expenses over the years, so I plan on enriching my knowledge in cooking, gardening and carpentry. I might take classes to become a certified weather spotter for the state, maybe become a master gardener or certified pitmaster (it takes all day to smoke a brisket; I can’t do that if I am working).
Fitness and health will be important, I hope to be able to lower my golf score and running pace. Maybe I will get to see my name posted at the gym for the most visits in a month.
I plan on spending some time traveling, we have some great sites to see in this country as well as locations overseas. I have always felt the obligation to plan travel a minimum of 6-9 months ahead of time as to not disrupt my already scheduled patients. Spontaneity will hopefully become my friend.
Of course, I will not be able to step away from medicine completely. I will look into volunteering at the local free clinic and I’m sure I would be a good standardized patient at the nearby medical school (DRE’s no longer recommended).
I have already agreed to do some very part-time work that does not involve direct patient care and I have been offered multiple other positions both within and outside my organization. My mantra has been not to commit to any significant obligation.
Would you do it all again?
Of course I would do it all again. Unless someone is so dissatisfied in their career, I am not sure how anyone could say otherwise. There is no way I could know how my life would have gone either in a different specialty in medicine or another career path altogether. I feel fortunate to have helped so many and all in all it has worked out very well.
I have two great kids, I have not pushed them in any direction as to their career choice. Both of them have studied science without an intention of pursuing medicine as their calling. My hope is that they find passion in whatever career they choose and enjoy life.
Related:
DocNextDoor’s Financial and Life Advice
You may want to listen to someone who is retiring with a withdrawal rate of under 2% after a 23-year career in primary care. I pulled some pearls that he shared in the WCI forum.
What does he recommend?
1. Go to a low cost school and get out of debt as quickly as possible. Admittedly, it helps to have parents who had planned and helped pay for their children’s education.
2. Marry someone with similar financial goals and if they can work even part-time, their retirement savings can be substantial.
3. Maximize all of your retirement vehicles as soon as possible and then add even more into an after-tax account. You will need that if you retire young.
4. Start saving for your kids’ education when they are born. 529 plans did not exist for mine but a $500 monthly investment for each covered their education and satisfies #1 for their future.
5. To succeed with #3 and #4: Live like a resident, and do not buy an expensive house, high-end cars, or join a country club. The house will be paid off before kids go off to college, expenses will stay controlled, and the now enormous pile of marshmallows can be eaten slowly for the rest of your life.
[PoF: Enjoy those marshmallows! I hope you’re enjoying your life without the dreaded inbox, fights with insurance companies, and are finding life after medicine to be all that you hoped for.
I was certainly surprised by your patients’ reactions, but I think their resentment is a testament to the good work you did for them and the prominent role you had in their well-being. Take their furor as a compliment.]
Capital One Venture X Rewards Credit Card
75,000 point bonus after spending $4,000 in the first 3 mo.PoF Summary
2 points per dollar spent (2% cash back equivalent). Up to $300 credit each year for travel booked on Capital One Travel, 10,000 bonus miles each account anniversary ($100 value). Unlimited Priority Pass Lounge Access, $100 Global Entry or TSA Pre✓ credit. $395 fee can be more than offset with travel credit & annual point bonus
Have you had negative reactions to your desire to retire? Are his patients out of line to feel this way and express it to him in the manner that they have?
My patient’s attitude towards me (retiring at age 62) was usually “Great, now you can take care of yourself for a change.” Now a few years into retirement, virtually everyone who sees me says “You look so relaxed now.” Sometimes I feel as if I am missing something – for example yesterday at about 1:30 PM. Easy fix – just remembered exactly what I would be doing at 1:30 PM at the clinic a few years ago. Lunch would be answering messages and looking at lab results until 1:20 PM then a bottle of Slim Fast followed by a jolt of caffeine before seeing my next patient ten minutes later, all done in an attempt to get home by 7 PM that evening. I feel much better, and take a nap instead of thinking about the past, my German Shepherd lying next to me 🙂
Good for you, Bill.
I rarely take naps, but that’s precisely what I was doing at 1:30 p.m. yesterday. But in my case, I needed it after finishing up a 72-hour call Monday morning (and placing a labor epidural in the wee hours).
I look forward to more relaxing times.
Cheers!
-PoF
I am glad I did not retire because of being angry at insurance companies or the EMR, or disillusioned with the practice of medicine or being overly tired of getting up at night to treat sick children, as did so many of those who have written in. I retired after 50 years of pediatrics because I realized that, while I enjoyed medicine, there were a lot of other things I wanted to enjoy more doing more of. I realized that I had not been able to get enough of those things because of medicine. When my older brother had a stroke I realized that if I wanted to do those other things I needed to do them while I had the good health to do them. I think I was fortunate to have enjoyed my life. I would hate to have spent my life doing something i did not enjoy, as so many of those who have written in seem to have done.
One of my most respected colleagues committed suicide in the prime of life. He was a great friend, a compassionate doctor, and an awesome surgeon. How I wish he had just chosen to retire early!
My long time and loyal nurse, same age as me at the time (57) died of ALS. Certainly had an effect on when I eventually retired.
As an Interventional Radiologist, my situation was a bit different. I had merely wanted to transition into a less than full time status. I wanted 5 days a week, no call, no weekends. I negotiated what seemed like a more than fair deal with my group, was required to resign as a partner, was paid per diem and life went on otherwise as before. After a few months, one of the partners released the results of an analysis of individual productivity in the group. Apparently I was the most productive IR in the group in spite of not working full time! The reaction of the other IRs was immediate. They threatened to stop taking call unless I was given notice. Thus started my locums career.
Ouch. Welcome to locums! I’ve done plenty and it’s served me well.
Cheers!
-PoF
Sadly, the greed of your other practice members is a trend I am seeing in every corner of medicine. Enjoy your locums assignments. I have found it very helpful in having only part time practice and long vacations as I desire.
Thank you. I worked locums assignments for the next 10 years until they stopped during the 2008 downturn. I enjoyed the experience and was pleased that I would invariably be offered full time employment at every place I was assigned. When things picked up again in 2010 I discovered that I was no longer employable since the liability companies would not cover me unless I went back into some sort of training situation. Thankfully I was set up for retirement by then. Their loss.
Wow, a lot to learn from this. Thanks to everyone (including Jack). I learned a lot:
1. Don’t broadcast your desires to retire early to colleagues
2. Don’t feel guilty for living YOUR life
3. Ignore the resentment/hate/envy/jealousy/selfishness
Congratulations!
I believe that what you have done is what many people dream about, whether they dare to nurture these thoughts, share these thoughts with their families, colleagues etc is a totally different question.
As is the question if they start to move in this direction. Perhaps they think it is to late, too hard or they do not want to downsize/ do whatever it takes.
There still seem to be a lot of shame around burn out. I think that if you manages to change your life in time before reaching burn out that is an amazing achievement. You should celebrate!
Thank you for sharing your story.
I have read all the comments totally amazed, so much positivity and utter negativity. If you get negative comments it could be simple envy other people who wish they could change their lives.
In many ways it is a healthier way to change career to change your life than for example getting a divorce, which seem to be so common.
I look forward to a time in the future where my employer will not be able to decide if I celebrate big holidays like christmas with my family and friends or not. Where I don’t have to plan my life 6-7 months ahead etc.
Does it make me a spoiled kid? I don’t think so. I don’t think that I had the imagination when I was 20 to know that it was this I was signing up for. I am not bitter, just trying to reconfigure my life so if better suits me, my personality and the people in my life. To help people have been my dream since I was 7 years old and it is fantastic. But the organizations (and I have switched work place on multiple times during later years so I should know) can really tear people down. No one wants to be reduced to a line in the schedule. We are not robots after all. If it was not for my mentor in my current work place I do not think I would have the stamina to continue, at least it would be lot less enjoyable.
I’ve already had “breaks” sabbaticals from my so called medical career. Financially not the best choices, but looking in hindsight I don’t know how I could have survived otherwise. Sometimes it is just better to quit than to stay in a place with to little air. During that time I also got questions “What are you doing now?” like if there is not more to life than work. Another favorite What are you know? when I am not a student, a worker, an unemployed. It sounded like I had no value if I did not have one of the standard roles. What about a fellow human being, a world and life explorer? I also got my share of “Don’t throw away your talents/the chances you have been given/your education/all your hard work/….(fill in the blank)”
Without doubt the questions would come back if I choose to change career or reach retirement ahead of time.
We have to be humble enough to reexamine our lives. What made us happy and helped us move forward in our 20s and early 30s are perhaps not what drives us later in life.
And possibly if you postpone all your dreams until you have reached by society acceptable 65 (this number will probably increase over the decades) you will not have the energy (or guts) to do all of them?!
All I know is that time is a very precious commodity that we can never get back.
Retiring early will give me possibilities of making new choices, and reach other life goals. And possibly even be a happier person, at least less overworked/stressed.
My highest motivator is my father who only reached 59. You never know what life has in store for you.
Good luck to you all,
all of you still striving for your number and all of you exploring a new phase in life.
And Happy New Year!
Congratulations DocNextDoor. Its remarkable to hear of people’s reactions, but I’ve always noted that when dealing with the public, one sees (and hears) it all. Focus on the good and not the outliers.
I do think the sentiment about what one “owes” is one that should be explored and discussed more. Not with the anger/venom of a comment (talking to you Jack!), but rather as a community, on what one’s personal view is on what one’s responsibility is to society.
I understand the desire to be free, but I hope some time in the future you will again use your skills and talents to improve some people. Those comments mostly were way over the top. I am retired but would like to do some work (not really for pay) to assist folks. Unfortunately my skills are not in that great demand.
Haha. I “retired” when I was about 36 years old. I am 50 now.
I was just good at school and it seemed like an easy enough career to do. I didn’t know I was meant to do it for life. If I did, I’d never have done it.
I was in primary care. I also worked mainly in clinics since I knew I was never going to be doing it that long.
I did not ask for permission to stop. And I don’t go out of my way to tell anyone that I am essentially retired.
I just live my life. It’s kind of simple.
I love that your are able to do that, but the missing information is: what do you do for a living now? Most of us work at a job we once loved, but now hate for the myriad of reasons that have been elucdated ad nauseum in so many treatises (EMR, the “govt.”, insurance companies, etc., etc., etc.). I believe we do so out of fear of loss of income and control (after all as a physician we could always quit and pack up and go somewhere else if we really wanted to). The leap of faith to quit is the bungee jump we can’t force ourselves to take (it is for me at this point). What was your safety net (or did you even have one)?
Hi Longhorn,
I had 50x my living expenses when I was 36 years old. I did not even know to compute it like that back then but I knew I had enough.
My plan was always to work 1 or 2- four hour clinic shifts a week even after I had made enough. That would have netted me 100K per year. (I am a self employed Canadian Doc and we have plenty of flexibility)
I slowed right down to be home with my kids. They are grown now.
I even went back and did a full residency for 3 years. But being a GP suits me best.
I would recommend working part time. I never had to really use my back up plan but it most certainly was there! I would have done it in a heart beat.
Many docs would be surprised how much happier they would be by simply working less.
Always interesting to read about docs actual early retirement experience. It’s not all unicorns and rainbows it seems. But you gotta do what’s right for you and ignore the rest. Great job and happy travels!
Just a quick comment as I was saddened by Jack’s reply. I chose to return to medical school at an older age, given a persistent drive to study medicine and become a physician. I even did 7 years of training to become a not so highly paid benign hematologist because I absolutely love the field (in contrast to my colleagues’ preferences for the more lucrative oncology field and against all those urging me to keep potential income in front of me). After 5 years of academic practice, I was exhausted from the call, patient demands, unsupportive colleagues, ongoing EMR changes and demoralizing administration. I left my job for fear of bringing the anger, resentment and sadness I felt daily to my patients and the workplace. I no longer had any innovative research ideas and I feared my complaceny would result in a medical mistake. No one has paid me during my time off; I did this because I prophylactically knew that I couldn’t be a good doctor if I wasn’t happy. Eleven months later, I am a happier person and excited to think about medicine again-but I realize that in our current healthcare state, this enthusiasm is on a short cycle to burnout. I wish we had the kind of medical system that my grandfather practiced in. But I know that when he retired in the ‘80’s, he was growing weary from the changes-after a 50+year career. Something has to give; none of us would seek to leave if the system allowed the healthy practice of medicine.
Thanks for all the positive comments. I have had no regrets. It has been 3 months and it seems like its only been a week. Not a moment of boredom, my days are full and fulfilling.
I am planning to fill in at a local clinic to help them out, this will be on my own schedule and with no long term commitment .
I also see many of my patients every time I am out in town, just yesterday a patient (who’s brother is also a pt) ran into me and said “My brother told me to tell you that he hates you” . I don’t remember that his name was Jack.
Enjoy life with a smile.
Congratulations DocNextDoor!!!
Your post really resonated with me. For my story, see my guest post that went up today on PoF- outlining some of the reasons I quit OB at age 43. I used the “DABDA” framework for understanding my decision (Denial, Anger, Bargaining, Depression, Acceptance). I noticed that these same themes rang through your post (great FIRE minds think alike!)
It’s been 3 months since I wrote that post and made my announcement. I have never looked back. The change in my mental health and happiness has been enormous. Some of my OB patients are upset that I won’t be doing deliveries anymore (but my previous participation in the group meant an only 1/11 chance of my attending their delivery anyway…I have not faced any of the animosity that you have suffered through and I’m so sorry you’ve had to experience that sort of attack).
Go forth knowing that you have 100% earned the lifestyle you are now finally able to enjoy, and don’t let the “Jacks” get you down!
All the best!
I wrote this on a different blog in September in response to an a** like Jack named Impromptu:
What a load of garbage. We MDs owe society nothing when it comes to how long we work. The time, effort and sacrifice we make, as well as the unpleasantness we have to put up with (EMRs, insurance approvals, etc) , absolves us of any responsibility to work until we drop.. Now I don’t know what you do Impromptu (I’m a Medical Oncologist) but given that me and my colleagues cure patients of their cancers from time to time, and/or prolong their lives and relieve suffering, makes me think that you may have to work until the day you die to have given back as much to society ?. No God complex intended – just making a point !
I had similar reactions like DND’s. I had a pain practice with some patient relationships of 5, 10, 15, 20 years. I had some Anesthesia relationships where I always was requested. Once I was at a party at my Church and realized I had taken care of 48 out of 50 people in the room at some point in some fashion, so my career was impact-ful, but my influence not eternal. I gave it my best shot and moved on. I did it till I was done. The blow back was variable, some happy for me, some disappointed from both patient and physician quarters, but in the end I decided I didn’t want to do that any more, and so I didn’t. Like Laura Nyro said: “and when I die and when I’m gone, there’ll be one child born and a world to carry on” Some how people are getting quality treatment without me. Leaving Medicine is not a big deal unless you make it a big deal, and once you’re gone you’re gone. Life goes on, both your life and the life of Medicine.
My only advice to DND is retirement is not about doing. Medicine is about doing. It’s about being. Discovery is about being, and being present in the moment. The luxury of having no future or past commitment is becoming present. Have a blast!
I did not realize that Blood, Sweat and Tears “And When I Die” was a cover song. You learn something new every day!
That’s incredible that you had taken care of 96% of the room. I’ve had plenty of repeat patients and I’ve taken care of three generations of at least one local family, but the relationship will never be the same as that of a primary care provider.
Now that my plans are known, people are more confused than anything.
Cheers!
-PoF
Congrats on being in a position to pull the plug. I know at age 51 I feel the cumulative stress of a 20+ career in medicine. Prior to that there was work, planning, pressure for grades etc. Add it up and I have been working very hard, very long hours for 33+ years by age 51. Cops, firefighters, soldiers routinely retire from service at 20 years. They may find other productive activities – some of which are for pay. It should likely be similar for doctors.
I push all doctors who will listen to me to achieve FI within 20 years of a medical career. A 38% gross savings (about 50% net) will get you to FI in 17 years. Start at age 31 and be set by age 48. Then you are empowered to make choices. I’m continuing to work in clinical medicine, albeit part-time. Others may be best to stop completely, keep up full time, or change fields. We are all on our own journey.
There is no shame in living a wonderful life. You have had a great career and have sacrificed yourself for decades. The fact that patients don’t want you to leave indicates how much you have helped them in your service. Be proud of all you have done. You will still do more great productive activity in your future. Let the haters judge all they like. Enjoy your life, and for now – some hard-earned rest!
DocNextDoor,
Kudos to you for reasserting control over your time. Wishing you well on pursuing your second act, finding meaning in work you choose independent of income, and the lives that benefit from your gifts.
Reading this thread, it is clear that immature or self-centered reactions are by no means limited to patients. Look out for the Physician Retirement Police! Don’t let the martyrs of medicine nail you to their cross, my friend. Keep shining as a beacon to other docs who feel stuck or helpless – your message of hope is important.
I’d quit worrying about what other think. Live your own life.
I’ve only seen jealousy of my hard work, not respect.
If I’d listened to my high school guidance counselor, I’d be working at the local bean mill for $15 an hour.
I retired at 58. Don’t miss any of it. Pursuing music and photography while having a great time. Should have done it 5 years ago.
Or could be like my childhood physician. Retired May 2018. Died December 2018. At age 88.
I had a different response when I retired. The doctors who said anything were happy for me and wished they could join me. I did have several patients and doctors say I was “too young to retire.” I would simply tell them “it doesn’t take age to retire.” They were good with that. I never got a strong negative response to my face.
I enjoyed my life as a surgeon and now I’m enjoying my life as an author who helps doctors. It might have helped that they all knew what I was doing in my retirement years. That I wouldn’t be on the golf course everyday. They saw my books and heard my financial teaching for years before I pulled the trigger.
Best of luck to you,
Dr. Cory S. Fawcett
Prescription for Financial Success
Thanks for sharing your experience, DocNextDoor. I would have not expected such an overwhelmingly negative response from your patients. It’s kind of disappointing, really.
I think people have to understand that doctors are human beings too. We have needs, feelings, emotions, values, and goals. And the needs of each human being is individualized. It’s a shame that patients and other doctors will try to shame you for making a decision that is ultimately to your (and your patient’s) benefit. The fact of the matter is… a doctor who is burned out (or over worked, or over stressed, etc.) will not be able to provide optimal care for their patient. In some ways, it can be harmful.
You made the right decision based on your personal needs. You should not be vilified and I don’t think you have to apologize or feel shameful about anything.
Be well and thrive 🙂
Congrats on the early retirement, that is amazing! You rock! I can related to all the hate…. i have people talk to me like this everyday… I’m a dentist!
I thought Jack was just being sarcastic at first. What d*bag would hold those views, let alone write those to somebody. You only became a doctor because daddy wanted to you, and now you sit on a high horse. I’ glad you never held my infant.
Sounds like the moral of the story is don’t tell your patients you’re leaving and don’t give your employer any more than the minimum required notice. And based on Jack’s reply….don’t tell any other doctors either. Who needs that sort of abuse? Give me a break. Life is too short.
Of course….I say that as someone who made a deliberate decision in medical school NOT to have long term relationships with my patients.
Congrats!
I am glad to hear that it is possible to retire early from primary care.
I have not decided if that is the route for me but I would like to have that choice and be able to retire when I get to my fifties if I so desire. I owe a big thanks to POF and WCI to making this possible. Your story was very inspirational as well. Thank you.
Wow, those childish reactions are disappointing; I really don’t remember being treated like that when I changed from office to hospital at age 42, but that was almost a generation ago. It makes me wonder whether it’s a reflection on society, or people today used to posting their opinions about EVERYTHING on social media.
I myself have lost 2 PCPs to career changes, and my reaction was a shrug and to wish them well.
Time is precious. For patients or other docs to judge you after an already lengthy career seems presumptuous. Best wishes.
This is Jack, one last time. I retired at 65. I loved the field of IVF. Things that I believed would never happen in my lifetime were standard operating procedure a year later. Wow! I was 40 when I reached my “mental number “ for retirement. Our home was paid for, children’s college funds were almost funded and we had traveled as a family to the far corners of this hemisphere.
I am not “shaming/berating” anyone. We all have choices. I understand burnout. I understand calling the 800 number to prepare for a procedure with someone on the other end with less than a grade school education. Then worrying about running a 7 member practice during flu season for everyone and their children.
However, I was a doctor. And I gave my time and effort to train interns and residents to the best of my ability. But, to give up MEDICINE for
“Personal Freedom” is shameful. You took someone else’s place and that is the reason for my pain when reading the responses.
Jack,
In the span of one paragraph, you state that you’re not “shaming” anyone and then go on to say, “‘Personal freedom’ is shameful.”
Yet, you put an expiry date on your tenure as a physician at the age of 65. Why insinuate that it is a calling on one hand while claiming your job is done with the other? Is it because 30+ years is “good enough” in your mind because you met your arbitrary goal?
This physician had a way out from the moral injury/burnout of healthcare and took it. No spot was taken – the physician competed for it, earned it and sacrificed for it. As you know, everyone has a different set of priorities. The wonder of IVF may have been enough to keep you in the game whereas the pressures of US Healthcare outweighed the satisfaction of primary care to the above physician.
Jack- you say “I am not “shaming/berating” anyone. ” Did you even read what you wrote? You don’t have to re-read the whole thing– just the first line. The FIRST WORD!
Jack wrote at
December 20, 2018 at 4:05 am:
“Shame on you for retiring early”
I will say shaming someone is sometimes appropriate. As in “SHAME ON YOU, DR. JACK!” How dare you? Have you never decided to do something and changed your mind? It takes a real JACK-a** to come on here and so brazenly dictate to others how to live their lives.
Your comments are inexcusably narrow minded, self-righteous, and ignorant. Tolerance of the intolerant is NOT a virtue.
Nobody agrees to do anything unconditionally forever. Medicine has changed. Not to everyone’s taste. If you like it well enough to go into it today, it does not commit you to do it forever no matter how it changes. Or even if it does not change. People change. People change their minds. Those that have them.
Others just mindlessly go around shaming people.
If you would have retired earlier you probably could have visited the corners of both hemispheres not just one…
Get back to work Jack! Your arbitrary retirement age of 65 isn’t old enough. To think you stole someone else’s spot in med school who could have made it to 75, 85 or beyond. Shame, shame, shame! Doctors loathing doctors. I have an idea let’s concentrate on transferring patient responsibility/health/decision making to the insurances and administrators who will definitively have their best interest in mind. Unfortunately, like so many doctors with your mindset, your lapse in awareness occurred much sooner than 65 when you transferred care to the jackels.
Based on the comment stream I think it is time for a Boomer doc/ Millennial doc truce. We actually have a lot in common. Let us help and support each other.
I am not sure this is necessarily a generational issue. As a relatively old Gen X-er, when hearing of my part time status, many of my Boomer colleagues, 10 years or more my senior, have responded that they wish that they could have cut back at my age and still wish that they could. More respect and perhaps envy than frank hostility.
This is a great, instructive piece, DocNextDoor. Congratulations to you for the career in medicine and the life you have built for yourself. I am sorry to hear about the negativity that greeted your retirement announcement, but patients/people usually think about themselves, first. Their disappointment is largely testimony to how well you treated them. Still…
If I could add one item to your “to do” list, as a retiree, it would be to continue to spread the word of your success. Could you lecture on financial independence at the nearby med school? Perhaps speak as an invited guest at national meetings?
Well done!
I retired last year. My immature patients could only see life from their point of view. They had the same reactions to news about health or other relationships. My emotionally healthy patients expressed sadness and regret and I do miss them
I don’t miss the interactions with insurance companies one tiny bit. I loathe EMRs. I’ve found joy in family and volunteer activities. You owe no one your life in medicine. Most of my practice was neutral or enjoyable. Removing the onerous parts was important enough to my soul and my family that it made the decision to retire simple. Had I managed my finances more effectively from the beginning I would have retired earlier. There is great delight in a sane lifestyle and adequate sleep. Volunteer medicine is quite fun. Congratulations to those who are able to plan and control their destinies. Fair winds and calm seas Doc Next Door.
Great post and thanks for sharing. I think this is a testament to your relationship s and work as a doc. It still sucks to be hit with that kind of.emotion but at the end of the day you have to do what is right for you. 51 isnearly but greatm, so nice work!
Jacks’ reply is for real. I am Jack. A physicians life is not easy. It is hard. I missed my wife terribly. I missed my kids games, friends, schooling et al. But, as I was told upon medical school entry, “ Get a wife, raise a family. Love them deeply. A family is necessary for a physician to return to each day. To breathe and to love and to hold dear. But never forget MEDICINE is a very jealous mistress and will want ALL of your time regardless”.
My wife, my family, understood this choice I made. Yet, at the end of the day we held each other closely. They loved their husband/dad being deeply loved and respected by many.
None of our 4 children wanted to become a doctor, nor marry one. BUT they made this choice before going to college NOT after college
Jack the choices you made are fine but please don’t use shame, the devil’s tactic to make others feel bad about their choices. God gave us all free will, you exercise your free will and others should be allowed to do so as well. All of us physicians have all missed many our family and special events. Shouldn’t we be happy for one of our colleges that he will not miss his family and special events anymore rather than shame him ?
Hmmm… maybe that’s why there is such a high rate of divorce in physician families? And it’s unfortunate that the initial advice did not also suggest – ‘get a husband…’
I am Jack’s Raging bile duct
Perhaps one of the reasons none of your children followed in your footsteps was because you had such a demanding mistress. I wouldn’t want my kids to go into a profession like you described. However, all my kids want to do what I do because I am able to go to most of their games and be there for my wife. I didn’t get married and have a family to support my decision to be a doctor, I became a doctor to support my family. I’m glad your family was able to support you through your life, I just want to be able to support mine how I can.
Thank you for sharing that story POF. I actually was surprised by the reactions received from the patients of anger (but of course as a radiologist who has minimal contact with patients I didn’t quite think out this aspect of medicine).
If I was seeing a physician who announced retirement early I would like to think I would be able to congratulate him or her. But I do get that some of these relationships can be decades old and it may feel like a divorce to them. I guess the bright side of this is that your patients have grown to trust you so much that you are like a spouse and act like you did file for divorce on them out of the blue. That meant you have truly made some strong connections.
I am glad, like POF, that my eventual exit will avoid this aspect entirely. It will be mainly with the radiology staff and other colleagues in the workplace that I would hope would be sad to see me go but happy for me as well.
Truly a great post and thank you again for sharing that.
Congratulations POF!!
Your posts and interviews have inspired me and helped me avoid many silly mistakes my first year out of fellowship.
Thank you for sharing your story and being homest about your feelings towards medicine.
Wow I hope Jack is being sarcastic. Maybe he hides his jealousy by shaming POF. Which defense mechanism is Jack displaying?
A. Projection
B. Passive Agression
C. Social Comparison
D. Displacement (maybe he had a bad day at work) ?
or
E. Rationalization
As POF said some of the reactions could probably be taken in a positive way since they seem to reflect that you were very liked as a doctor and did a great job. But the others…. fuggetaboutit.
Congrats to you and good luck getting that running pace down.
Easy Rider, 1969
Jack Nicholson:
DH:
JN:
DH: M
JN:
https://www.youtube.com/watch?v=bYsztoaU9Ls
Thanks. I’ve been putting in the miles, 140 since exit, and getting the pace down to close to 9 min mile, hard to keep up with the youngsters in my run group.
Whoa, is Jack’s reply for real? What an intriguing interview. Yes, you chose to be a doctor and you can choose to get out. You are a human with your own volition. Thank you for helping those you have helped. There are similar but more veiled sentiments directed towards women when they go out for maternity leave, so I’m not wholly surprised. People have said to me things like, “keep your legs closed” or “enjoy your vacation.” It’s disgusting. Saying you’re planning pregnancy gets similar reactions.
https://www.thefrugalphysician.com/docs-planning-pregnancy/
I love the nod to the marshmallow experiment haha.
I am truly surprised by the comments of your patients, but I guess that reaction makes sense knowing how humans are in those kinds of situations. I was also surprised that your colleagues handled it positively.
Keeping expenses low while you pile money into investment vehicles is certainly a great way to get to financial goals fast. I have made some of the mistakes you mentioned (car, country club) but at a modest price (i.e. my country club had no initiation fee and is the cheapest one around – I play enough golf most months to easily recoup the cost).
I think it’s okay for people to live a little, if they are doing most things right. We lived on 20-30% of our income the first year and a half after finishing to pay off our loans (200k in 21 months).
Thanks for sharing your experience and for being a great example to the younger doctors out there!
TPP
Shame on you for retiring early. Your medical school faculty, your mentors, your training, your facilities, were provided you because you CHOSE to become a physician and help people. This was to be a lifelong career because you were blessed with a great brain and talent to be able to heal your fellow man.
My father wanted his sons to be doctors because they “ would be able to drive an Oldsmobile and always have butter on their table”. Not to make a lot of money as quick as possible and then get “out”.
Had I retired when I had reached my “ number”, I would have missed 25 years of advancing medical initiatives. I would have never met the 7000+ infants born through our medical practice. I would have reached my now age of 76 ashamed of wasting my talent to live how “I wanted to live”. I became a physician because God gave me some kind of “talent” he didn’t give others. Shame n you.
Jack,
I think you’ve signed up for the wrong blog.
Your answer is priceless! Some old people don’t give up medicine for ego, nothing related to serving people. Pure BS.
Jack, shame on YOU for being a d***.
Medicine is not indentured servitude. A doc can and should quit whenever he/she chooses.
I still enjoy my career, but when I decide to retire, I’m not going to worry if Lord Jack thinks I’ve worked long enough.
Think Jack is mocking the patients.
Gars, I cold be wrong, but I don’t think he is.
Typical reply of the baby boomer generation- Shaming others because their choices don’t match what you think everyone “should” do. Well don’t should on the rest of us. We are all individuals, endowed by our creator with the ability to make choices that are right for ourselves, our families and yes, our patients. Burnout is real, it kills people.
This physician made the right choice for himself. You, evidently feel you made the right choice for yourself. Neither negates the other. Choosing med school obligates you to no further path, regardless of what others may say.
Congrats to the physician in the article on his early retirement. Enjoy!!
Jack does not speak for all Boomer Docs. I am also a Boomer OB/GYN. I personally got tired of getting up and running to the hospital at 2AM. I think medicine has changed quite a bit and burn out is real. Every doc should be allowed to wind down and exit when and how they see fit. I have a friend who still practices and operates at 82. Medicine like life is very individualized. I had some angry OB patients when I went to just gyn. My internist is taking a job at the local med school. I am not mad at him. I wished him well. My dentist retired in her 30s. Her family took precedence over my teeth.
“Her family took precedence over my teeth.”
That’s put beautifully.
This article was shocking to me. Kudos for making your own decisions, I’m glad we live in a country where you have agency over your life. I’m amazed but some of these comments, wow, really? Sheesh.
Thanks for your dedication to your career Jack and I hope you continue to work as long as you are capable.
Jack –
Your comments are despicable and characteristic of a generation long since past. A generation that was one dimensional, sexist, neglectful of their families and other responsibilities. Your tired rhetoric has no place here.
Congrats to docnextdoor. You should be proud of all the great things you’ve done and will continue to do. Get yourself balanced.
Logged in just to say Jack you’re an a**.
Medicine has left US not the other way around.
I’ve got a med/mal target on my back 24/7, pt’s with entitlementosis every single day, and I spend most of my day fighting my EMR rather than seeing patients.
You lived through the glory days and made a fortune doing it I’m sure. Now we earn a fraction of what you did and it still isn’t enough to make up for the crapstorm we call the modern medicine factory.
I’m the hell out soon and if you don’t like it I couldn’t care one bit.
Jack, I have read all of your posts on this thread. You retired 11 years ago at age 65, and I think that you have lost touch with what is happening in medicine. Your comments ring hollow.
I do not recall signing any contract guaranteeing that I would practice medicine until a certain age, or for a certain number of years, and neither did you. In fact, one could argue that you should have worked longer (or more weekends or longer workdays) to “benefit society”.
If the American public wants docs to stay in their field longer, the public will find a way to make the job better. Sadly, the job for most is getting worse. I fear that there will be no lone left to take care of me (53) when I get old. ?
Jack wrote his comment at 4AM that might be part of his problem !!! I’ve kept no secrets about me retiring year end of my 59th birthday. have been an aggresive saver, funded my kids 529 at birth so college was paid with the click of a mouse. paid off my house in only 15 years and will have worked 28 years and although I still get the “thats too early to retire “ , I don’t feel i will owe anyone anything at that point. I want some good healthy years to enjoy my 150 acre farm , river house , greenhouse , salt water reef aquarium hobby, flying my plane , gardening , family, plastic modeling, traveling , rescue dogs, and yes increasing my physical activity ( although i did walk / treadmill almost 3000 miles last year ) I will miss the people i work with ( office / OR) and SOME ! of my pts . especially the ones I’ve taken care of for 20+ years , and hope they continue to drop by my house anytime with seafood , venison, cakes , cookies etc or just to visit . I will miss using the tricks and experience gathered over the decades getting stones out or foleys in . I will not miss the call or the daily grind of the office , the BS EHR , and the unreasonable people and demands . nobody should give you any grief if you want to retire early . I would just recommend having a well deversified actvity schedule. watching price is right everyday and organizing your stamp collection will get old fast !!!
I have just concluded my thirty-some year anesthesiology career at the age of 63, and you have touched most of the things that drove my decision process as well – enjoying the people I worked with and cared for, but feeling relentless production pressure in the face of dealing with an EMR system that seemed designed to turn me into a machine. I also encountered some life events, like hypertrophic cardiomyopathy, sarcoidosis, and autoimmune colitis, along with the death of my wife, that enlightened me with respect to my own mortality and led me to the conclusion that retiring when you want to is far superior to retiring when you have to. Continuing to practice as long as you wish is a noble pursuit, if you can still provide good care and you still enjoy doing so; but I’ve never met anyone in medicine who signed a pact to work until they dropped dead in the harness.
Jack,
There is no shame, and in fact there is a great deal of wisdom in knowing when it’s time to stop. I wonder whether you were very judgemental toward your patients as well.
You are lucky to have made it to 76. Try working 40 years in a steel mill or being totally disabled from war wounds.
Unless you know what a lot of doctors have gone through you have no right in my mind to judge others.
There is a saying “there are more old drunks than doctors”. Too many docs lost too many years of sleep because of night calls for which they received little to no compensation. Most docs wanted peace of mind and didn’t get it from working frequent night calls and then going back to the office the next day.
It has been worse in the past 30 years because most employers only care about money and what the slave doctor brings in.