Although physicians have always worked longer in their careers than other professionals, the increase in longevity means even they must plan for retirement. In this article, we explore the challenges for physicians who seek a career transition in the later years of their medical careers and discuss the timing of this as well as how to replace work with other meaningful activities and maintain social connections. We also offer tips for successful retirement, including the need to plan ahead, prepare financially, and explore hobbies and activities in advance.
The retirement age for physicians has increased over the last few years. Physicians have always worked later in their careers compared with other workers,1 as many enjoy the meaning their work brings to their lives as well as the interactions with patients. However, as physicians age, their competency can decrease and affect their ability to practise safely. Some may lose their enthusiasm or passion for medicine. Top
The challenge we are facing is the increase in longevity and how to best plan for these extra years. We are living 10–15 years longer today, compared with life expectancy in the 1970s.2 Planning for these years, our “third act,”3 is the key to living a happy and meaningful life. These years will not be what is considered traditional retirement, but busy and active, often including what we call an encore career.
In 2013, over 41% of Canadian physicians were 55 years of age or older.4 These physicians will need to plan their life for the next 25 years. Evidence points to few of us planning appropriately, with the risk of unfortunate consequences.
Some physicians and their spouses look forward to a life of leisure. Playing golf, traveling, and more time spent with grandchildren can be satisfying during this part of life. However, we know couples of which one would love to travel, yet the other has no interest in that; thus, they do not travel, and one of them is very disappointed. After retiring from a fulfilling career and spending five years playing golf and skiing, a close colleague commented, “Is this all there is now to life?” A retired friend, not a physician, spends a good deal of time negotiating a better cell phone plan, but this would likely not satisfy most physicians as a meaningful, passionate retirement activity. Top
Challenges of transition
The challenges physicians face when they leave practice are several. The first is in knowing when to stop. Some can successfully reduce their practice, working on a part-time basis until they finally quit. Others whose practice may be hospital-based, e.g., surgeons, often cannot gradually decrease their practice and often leave abruptly. Some are asked to leave sooner than they wish to make room for a younger physician with newer skills. Some find the necessary burden of being on call to maintain their access to hospital resources just too difficult. Still others recognize a serious deterioration in their skills.
To live a rewarding third act of life, physicians need to replace their practice with other meaningful activities about which they can be passionate. Their personal value has been tied to their role as doctors, providing care to patients. But when they leave practice, this will be lost: they are no longer physicians. Some articles suggest this is the time to prepare to be a “nobody.”5
Physicians’ social networks often revolve around their medical careers. When they leave medicine, this network can be lost. Maintaining a strong social network is the key to happiness. Top
Staying healthy through physical activity is important. During their careers, many physicians are too busy to be involved in regular exercise; they should consider making time to do this in retirement.
Risk of dementia is a real concern; many physicians have seen the consequences and the burden of this disease. Carol Dufouil, a scientist at France’s Institut National de la Santé et de la Recherche Médicale, and colleagues showed that the risk of dementia is reduced by 3.2% for each additional year one works beyond 60.6 Thus, a working 65 year old has a 15% less chance of suffering from dementia than someone who stopped working at age 60. This is evidence supporting the expression “use it or lose it.” Retirement, it has been reported, can also increase the probability of suffering from depression by up to 40%.7 Physical activity can decrease this risk.
For couples, adjusting to these times can be difficult. Unfortunately, the divorce rate for older couples (“grey divorce” or “silver separation”) is increasing. Divorce at this age can be the ultimate wealth destroyer. Top
Spouses may not have the same idea of what to do during this act of their career. In July 2014, the Royal Bank of Canada published a report containing some interesting, but disturbing, facts.8 The vast majority of couples do not discuss these three key questions:
Only 36% of couples discussed how they will finance their retirement and where they will live once retired. Other observations from this study included the fact that men expect to spend more time with their spouse or partner, but fewer women expressed the same sentiment. Women are more interested in spending time with other family members and friends. Top
Couples can often have a difference of opinion over when one should retire, particularly when both are working. One article suggested that professional women have the most difficulty transitioning to retirement.9
Toward a successful retirement
The most important step toward enjoying these years is planning. Planning — together with one’s spouse — should start 5–10 years ahead of time. It may well include taking a mini-sabbatical of at least 3 months to explore activities and opportunities to enjoy as a couple or separately in an encore career.
Understanding one’s financial situation and doing some financial planning are crucial. One advantage of part-time work or activities is the potential for some additional income to supplement savings. This can make a significant difference in terms of the activities, e.g., travel, that one can fund in retirement. Top
Many physicians looking to pursue a hobby or volunteer work may wait until they leave medicine before becoming involved. This is not the best approach. We advise physicians to take up these activities gradually while they are still working. Thus, when they stop medicine, they are able to ramp up their participation easily, knowing this is something they will enjoy.
There are champions of the “never retire lifestyle,” who claim that staying in the workforce doing meaningful and satisfying work keeps one engaged, intellectually stimulated, and healthy. They would agree that the best retirement, perhaps, is no retirement. It is said, “He who retires least, retires best.”
1. Pong RW. Putting away the stethoscope for good. Ottawa: Canadian Institute for Health Information; 2011. Available: https://secure.cihi.ca/free_products/HHR%20Physician%20Report_En_Web.pdf (accessed 2014 Aug. 19).
2. Population Division. Demographic profile of the older population. In World population ageing: 1950–2050. New York: Department of Economic and Social Affairs, United Nations Secretariat; 2002. Available: http://www.un.org/esa/population/publications/worldageing19502050/pdf/90chapteriv.pdf (accessed 2014 Aug. 19).
3.Bronfman EM and Whitney E. The third act: reinventing yourself after retirement. New York: Penguin Putnam; 2002.
4. Basic physician facts. Ottawa: Canadian Medical Association; 2013. Available: https://www.cma.ca/En/Pages/basic-physician-facts.aspx (accessed 2014 Sept. 17).
5. McCaw D. Tips from happy retirees. RetireHappy.ca; 2014. Available: http://retirehappy.ca/tips-from-happy-retirees/
6. Dufouil C, Pereira D, Chêne G, et al. Older age at retirement is associated with decreased risk of dementia. Analysis of a health care insurance database of self-employed workers. Alzheimer’s & Dementia 2013;9(4):P342–3.
7. Work longer, live healthier: the relationship between economic activity, health and government policy (discussion paper 46). London, UK: Institute of Economic Affairs; 2013. Available: http://www.iea.org.uk/sites/default/files/in-the-media/files/Work%20Longer,%20Live_Healthier.pdf (accessed 2014 Aug. 19).
8. Silent partners: majority of Canadian boomers have not discussed retirement with their spouses or partners, RBC Poll finds. CNW 2014;July 16. Available: http://www.newswire.ca/en/story/1387479/silent-partners-majority-of-canadian-boomers-have-not-discussed-retirement-with-their-spouses-or-partners-rbc-poll-finds (accessed 2014 Aug. 19).
9. Think men struggle to cope with retirement? For women, it can be even tougher. MailOnline 2013;July 10. Available: http://www.dailymail.co.uk/femail/article-2359614/Think-men-struggle-cope-retirement-For-women-tougher.html (accessed 2014 Aug. 19).
10. Don Zimmer’s life lesson: never retire. Wall Street Journal 2014; June 5. Available: http://blogs.marketwatch.com/encore/2014/06/05/don-zimmers-life-lesson-never-retire/ (accessed 2014 Aug. 19).
Chris Carruthers is an orthopedic surgeon and a founding member of the CSPE, is currently enjoying his third act as a health care consultant and corporate director in Ottawa, Ontario.
Mamta Gautam is a psychiatrist with 25 years of experience treating physicians and physician leaders, is also a coach, author, and president of Peak MD, Ottawa, Ontario.
This article has been reviewed by a panel of physician leaders.