PERSPECTIVE: The journey to retirement for physician leaders
David Mador, MD
Mador https//doi.org/10.37964/cr24718
You have risen to a senior medical leadership role — the culmination of your administrative career. You have decided that the time is right for full retirement in the next one to three years and that this “retirement” will not entail continued medical roles or activities. Your family is strongly supportive. You have an adequate financial plan and have developed or considered other interests to keep you occupied and stimulated in retirement.
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What, then, are some of the aspects to be considered as you embark on this relatively short journey of transition? What are the unique qualities and competencies of medical leaders that will affect your route? In other words, how are you going to get from where you are today to where you want to be in the near future? A myriad of books and articles have been written about planning and considerations needed for a successful, rewarding retirement, but little specifically about how to deliberately plan the journey to retirement.
Based on my personal experience and observations of other colleagues, I would like to share some thoughts about the transition options available to physician leaders. Top
Unique competencies
Senior medical leaders come from academia, health care administration, the regulatory world, or medical politics. They have generally had interesting and varied careers that have enabled the development of a veritable potpourri of skill sets, depending, of course, on where their career took them. The opportunities to develop competencies in leadership far removed from traditional medicine are substantial and, by retirement, physician leaders may be expert in information management or technology, Quality, finances, capital management, research, teaching, etc. Some are acknowledged as exceptional leaders, something to which all physician leaders aspire, but may not have achieved.
In Canada, most physician leaders still have clinical roles, although these contract as their leadership roles expand over time. In some cases, they retire from active clinical practice to enable more focus on administrative work, as I have. However, generally, all medical leaders have a solid base of clinical competencies to add to their resume.
Whatever the acquired skills may be, their combination with a clinical background means that medical leaders contemplating retirement will have many options. In the vignettes that follow, I explore some of these options and what we might learn from them. Top
Options for retirement
Close the door and turn off the lights
Doctor Decisive had a wide variety of medical leadership roles, culminating in a major 0.8 FTE commitment. She retained a small clinical practice supported by her hospital, but is an avid baker, traveler, reader, and grandmother. She was content and felt fulfilled with her professional career and achievements. After much thought and reflection, she set a full retirement date about 1 year ahead and continued to work full time until that date. She left on good terms with her team and her hospital. Now, several years later, she is happy in retirement and has no regrets nor does she miss professional life.
Learnings: Some leaders are quite comfortable with an abrupt transition to retirement, but even this example was a planned deliberate approach. Implicit in this approach is the need to have actively planned out what the retirement state will entail. Top
Return to clinical practice
Doctor Clinician had a varied administrative career as a medical leader. However, his work had become less engaging and more “same old.” He had achieved most of the goals he set for himself several years ago and had developed a good succession plan that he has confidence will leave his organization in good shape.
He noticed that he continued to relish and enjoy his limited time in clinic, seeing and helping patients. He did not feel immediately ready for full retirement and, after discussion with his colleagues and a planned transition period, which included some clinical refresher courses, he returned to increased part-time clinical practice. He is currently enjoying both his work and partial retirement and plans to continue for a couple more years before full retirement. Top
Learnings: This might also be titled “back to our roots.” For many physician leaders, part-time clinical practice can provide the adjustment period needed to transition to retirement from the high stress role of physician leader. Attention to clinical expertise/competencies and collaboration with colleagues is key.
There is also mention here of succession planning as a fundamental and satisfying activity. Indeed, some would suggest this is the most important legacy piece of a senior Leader.
Something new
Doctor Academic was involved in the Faculty of Medicine in various leadership roles for over 20 years. She was thinking about retirement when she was approached by the CEO of her hospital to consider a new 0.4 FTE role to establish and develop a formal Department of Quality and Innovation. The CEO was looking for a 3-year commitment and considered this an important initiative. Doctor Academic found herself stimulated by the potential of this new role and the aspect of creating something new both for the hospital as well as for herself. In addition, she realized that a 3-year commitment would probably provide a perfect time-frame in which to complete her career. Top
After a year in the new role, she is very happy and engaged with work. She has been developing new skills and expertise and finds this invigorating. She has almost completely tapered off her clinical practice and is learning to enjoy the additional time off. She has started to think about succession planning with the goal of complete retirement at the end of her term.
Learnings: New opportunities that may unexpectedly arise offer stimulating work, but at a different pace. For some, this combination may be a perfect fit. In this case, the opportunity arose because of general leadership skills and experience, not because of specific interests.
Becoming a consultant
Doctor Advisor had been involved in administrative roles at his hospital for many years in a variety of capacities. As he approached 60 years of age, he found that he was far busier than he wished to be. He found the ties of his remaining clinical practice burdensome and was not feeling stimulated by his administrative work. He wanted to have more time off for his personal life (including a new passion to learn to cook with a smoker grill). Top
Over his career, Doctor Advisor had been approached to provide advice on external projects, but had not been able to do so because of time constraints or a conflict of interest. Two years earlier, he was approached by a consultant group to participate in a request for proposal from another province. The bid was successful, and he found the work engaging and stimulating. Other organizations showed an interest in his consultant expertise. He decided that a part-time career for a few years as a consultant was appealing and that he wasn’t really concerned about the uncertainty involved in such a career move. He was confident that there would be some work and that he would enjoy this. Over about a year, he retired from his administrative and clinical roles and subsequently pursued and developed his new contacts.
Two years later, he is as busy as he wants to be, working perhaps 12–15 weeks a year. He picks projects that he has a personal interest in and finds this very satisfying. The work blends easily with his personal life (he has become a good pitmaster). However, he has no desire to continue working indefinitely and has set age 67 as his final retirement goal.
Learnings: This is a common scenario that can go either way. Because of the limited project-orientated nature of the work, it can support a transition to full retirement or a longer term part-time retirement strategy. Top
Something new (again)
Doctor Builder is a senior physician leader who had a varied career. During the years spent working in a major academic hospital, he participated in a major hospital redevelopment. He interacted with planning consultants, architects, and construction companies and developed a passion for understanding how clinical need should drive the capital construction process, as well as a unique set of skills and expertise. One of the partners of the architectural firm that he had worked closely with went on to become the province’s deputy minister of infrastructure and approached him about considering a role as clinical advisor in the department. He considered this a unique and exciting opportunity and did not hesitate to leave his current work and accept a three-year position at a 0.5 FTE with a firm intent to retire at the end of that term. Top
Learnings: In this scenario, a skill set and interest acquired during one’s career develops into new interesting part-time work. Many such opportunities exist because of the varied careers that medical leaders experience.
Planned decompression
Doctor Deliberate achieved the role of vice-president of a large academic regional health authority — a high-intensity, high-stress job with a wide array of responsibilities. After several rewarding and stimulating years, he began to notice the toll this was taking on his physical and mental health and started planning toward retirement. Believing that an abrupt full retirement would be a difficult adjustment, he chose to organize an orderly, planned, and gradual transition over a few years.
He analyzed his strengths and skills and cross-referenced them with his interests and passions. He looked at the needs of his organization and developed a role description for a new part-time position that would serve it well and keep him personally engaged and productive. This lower stress, part-time work would give him time and opportunity to ease up and achieve a better work–personal life balance. After significant discussions and negotiations with some of his colleagues, the role was created and the transition occurred.
A year later, the organization was finding great value in Doctor Deliberate’s work, and he remained engaged and stimulated. Of equal significance, he started to develop some personal interests and enjoy time with his children and grandchildren. After year two, the work time commitment was further decreased with full retirement in the immediate future.
Learnings: Organizations are often too busy to proactively consider the creation of a new role that can be helpful to both the organization and to a leader in transition. However, it may not be difficult for a leader to take the initiative and “sell” a new role to their organization. This is a classic win–win scenario. Top
Informal leadership
Doctor Generous has decided not to renew her leadership position and is planning to retire fully in the next few months. However, she remains passionate about the importance of physician leadership to the Canadian health care system and wonders how to continue to promote it in an informal, unpaid way. For the last few years, she has been attending the Canadian Society of Physician Leaders’ annual conference, which she has found very rewarding, and has developed a good network of contacts. She decides to maintain her membership even after retiring from active work and to continue to attend annually. She hopes that she may be able to contribute to CSPL by volunteering to be on the meeting planning committee or, perhaps, creating a workshop of interest to the members. Top
Learnings: This is another example of an activity that may be time-limited or more long-term. It might be more appropriately considered a retirement activity rather than transition.
Back to the drawing board
Doctor Tentative has “done it all” in a long and varied clinical and administrative career. About 2 years ago, he retired from his leadership role, but continued with a part-time consultative specialty practice. He developed several outside personal interests and, after reflection, convinced that he was ready, he finally retired fully. After 6 months, despite being quite active, he realized that he missed the social and intellectual stimulation of his previous work. He reached out and, in no small part because of his extensive and varied skills, his previous organization quickly re-engaged him in a consultative administrative role. He is working two days a week and is happy with this balance between work and partial retirement. Top
Learnings: Full-time retirement is not for everyone. For some leaders, continued work is integral to their sense of self and well-being, both intellectual and social aspects. However, the challenge is how to monitor the value of our work and our competencies as we get older. In addition, this is not an indefinite state and, at some future point, the journey to full retirement will occur and the challenge of transition remains. Top
Discussion
Personal finances, personal and family health, family support, and personal interests/activities are major factors in making the decision to retire. Although these factors are critically important in determining the approximate timing of retirement or indeed deciding whether we want to retire at all, the intent of this opinion piece was not to delve into them, but rather talk about the journey. This topic has been neglected in most discussions about retirement. However, for most of us, once we have decided that we are going to retire and have some ideas about timing, the challenge remains: how are we going to get there? How can we, at least in part, address the potential loss of meaning? As the above scenarios have illustrated, the journey to retirement is highly personal (like retirement itself) and may take place over a short timeframe or over many years. Top
I believe that personal engagement and buy-in is important for a transition to full retirement to be effective and gratifying. The L (Lead self) in the LEADS framework suggests that self-awareness and managing one’s own performance and health are characteristics of a strong leader. I suggest that the retirement journey phase of leadership requires these same characteristics and that serious reflection and planning will be a rewarding activity.
If you believe that some sort of transition toward retirement is best for you, what are some possible considerations? Although some transitions may be quite obvious and require little active planning, others may need some degree of innovation. What are some aspects of your present or past work life that still interest and stimulate you? Analyze your strengths and the special, perhaps unique, skill sets that you have developed over the years and then consider whether any of these could fill a need for your organization or perhaps another group. Top
Is personal advocacy required? With whom do you need to discuss your thoughts, and do you need some personal support in your journey? Perhaps a mentor or friend could provide valuable advice and guidance. Not all of this planning has to be done alone. Have you been approached recently with opportunities (either internal or external) that you initially rejected, but might reconsider in the context of this transition.
In general, I believe that a slow-down or part-time role will likely be the most effective strategy leading to full retirement. Senior medical leadership roles are usually time intensive and quite stressful (whether we realize it or not); so a transition that involves fewer hours and less stress is likely to be effective. Most of the scenarios above highlight these types of transitions. Top
Conclusion
Retirement can and should be a rewarding part of our lives. However, getting to that retirement date does not necessarily happen automatically or organically. The rich and varied experience and competencies of physician leaders create the opportunity to organize and plan the journey to retirement, instead of taking a more passive approach. I believe that this deliberate approach will result in a smoother transition and, ultimately, improve our long-term satisfaction and contentment. For those of you considering retirement, I hope this discussion helps you approach the journey differently.
Disclaimer
The scenarios described above are mostly fictitious. They are based on my personal experience and observations of some of my colleagues as they proceeded along their own retirement journey.
Author
David Mador, MD, is a urologist, who had a successful 30-year clinical career centred at the Royal Alexandra Hospital. He has held a variety of senior medical leadership positions culminating in a four-year term on the executive of Alberta Health Services (AHS). Subsequently, he continued on a part-time basis with AHS as senior medical advisor with significant ongoing work in the development of the provincial clinical information system. He is now fully retired.
Correspondence to:
This article has been peer reviewed.