On Balance | So... You're Thinking of Retiring?
I don't play golf. But years ago, while on vacation, I was persuaded to play a round with two friends. Set to go on the first tee we were asked if we could be joined by a "fourth."
"What do you do?" I asked.
"I'm retired from being a doctor," she answered.
"I play golf every day."
Then she added, "I hate it."
That memory distills our greatest fears as we physicians approach retirement.
What if I hate it?
A COVID Aside
I wrote this article before our "usual" world became unrecognizable.
Thank you Mr. COVID for reminding us the universe is not beholden to humanity.
But there are bits and pieces of COVID-related issues from "inside" my article that relate to our new world order, and retirement from it.
Want to do something that helps with patient care and keeps your brain in gear?
Telehealth visits, reading EKGs or chest films (or whatever) are in demand. Step up and help your colleagues and hospitals that are overwhelmed and understaffed through these strange times.
You might even be paid for those tasks!
Or think of this: What better way to ease the stressed-out feeling that isolation breeds than to initiate your new hobby(ies) and do something totally enjoyable that is "yours"? That avoids counseling, meds, and even yoga (difficult with bad shoulders, backs and knees) and might even produce something of which to be proud!
Retirement is not an easy decision. Can I change my mind? Can I just give it a try, and if "I hate it," go back to my practice, my group, my hospital, my medical school staff?
There is a quick answer to that: highly unlikely.
Though we think our patients love us, students admire us, colleagues need us, the group depends on us and our hospital will fail if we left, the harsh reality is that after a few weeks our absence is hardly noticed.
The ship sails on, leaving a short wake that soon becomes a flat sea. So, here are a few thoughts on retirement that might help those who are thinking of what lies ahead.
Thought #1 is always the same, but difficult to address. How much money do I need? There's no single answer, but you can get close to one with some intrapersonal research. Start with thoroughly listing all expenses.
You'll need health care insurance – something probably not evident before, as it was part of salary deductions.
Going forward, Medicare alone does not cover what you'll need! The additional insurance is expensive! Don't forget the trip to Italy you wished for or the fishing trip to New Zealand.
Tally it all up. Now research the income side.
Remember, if you have a retirement account of any kind, federal and state income taxes are levied against your withdrawals, just as they were levied against your annual work income.
These withdrawals are mandatory after retirement. The amount you withdraw (after taxes) will be your disposable income going forward.
Roughly, that dollar amount (at least) needs to cover your expenses each year. Unfortunately, the multiplier of the number of years you'll be around after retirement is unknown. You might ask Mother Nature, but it's unlikely you'll get a definite answer.
Candidly, the advice/expertise of a financial advisor takes much of the financial anxiety away. It's worth the money spent for their counsel.
I decided to leave my work in the cath lab for two reasons. My L4-L5 joint spaces gave me back pain that told me it was time to stop wearing lead, and my wife looked at me one evening after a long day of TAVR's and told me it was time.
It helped that the Structural Heart Program at Emory had matured to a transition point at which my colleagues were ready to step in and take over. This is the hardest decision, but a long, hard look in the mirror on a cold, gray morning helps. I've now been retired for close to three years.
I thought I never would retire – and in reality I haven't.
This brings up Thought #2 – relevance.
Our life in medicine keeps us relevant. We ride on a relevance go-cart. We teach medical students, colleagues, fellows, residents and patients; and we earn CME credits, learn from colleagues, trainees and our patients, go to meetings, listen to lectures, etc.
Suddenly retirement makes all this unnecessary. One might think that's a good thing. Being relevant, however, for most of us is an important part of what we are.
Being useful in the huge machine that is medicine is what makes it fun to be a physician. We are "needed." This goes away.
Incidentally, it's remarkable how quickly the cutting edge of medical knowledge disappears from our brains. The ship moves on.
But even in retirement we have a valuable and unique resource – experience. Use it! Find a hospital with a weekly cath conference or cardiology grand rounds and ask to attend.
Most VA hospitals have associated training programs that would appreciate your input. Volunteer your accumulated expertise. You probably won't get paid, but that's not the point. You'll be appreciated and feel that you are, indeed, still relevant.
I meet with the Emory cardiology research fellows once a week after I attend the weekly interventional cath conference. We "mine" the database and I help them write papers for cardiology journals.
I also spend Thursday mornings at the local VA hospital in their cath conference. So far, it seems, they appreciate my attendance and what I contribute. Look around for other opportunities such as being a physician in charitable health care clinics or other medical venues.
Medical industry may need a consultant. You now have more time – ask around! You'll be surprised how cloistered your life in cardiology was!
So, for me, two days (or more) are already accounted for by trying to keep relevant – while I'm still making a contribution to others and to myself!
Thought #3 – Can I otherwise keep busy? Ask most retirees if they keep busy and you'll likely get the usual answer: they're much busier than they ever thought possible.
Turns out you can sleep later than the usual pre-retirement 0600 hours. I found out I was (deep down) a lazy person and sleep until 7:30 or later on my "off" days. One or two extra hours of sleep makes me ready for a day of doing things I never did before.
Who took care of all the household chores, food shopping, meeting the Comcast repair man, going to the post office, mailing packages at UPS, cleaning gutters, etc., etc.?
Probably not the doc in the house! Turns out sharing the usual chores produces constructive opportunities at home you never thought of – including talking with your significant other. Add another day of useful activity.
Thought #4 – If you have a hobby, now's the time to actually do it intensively, instead of catch-as-catch-can. I learned to do woodwork in high school and loved it.
After med school, an intern's salary was meager and expenses were carefully evaluated. My woodworking skills allowed me to help furnish our first apartment in Boston, then our first house, and the second.
Twenty years ago, when I moved to Atlanta my neighbor had a lathe, and I was smitten with turning hollow-forms. (After two months of weekends at his house, his wife asked me if it was not time to buy my own lathe.)
Today it's dangerous to ride with me in the car as any tree down in a yard or on the street is fair game for my chain saw and then the lathe. I brake suddenly.
I've even found a school in Atlanta that has an annual Art Fair; we share my sales 50-50. It's not a great deal but we both benefit (and my wife loves seeing all the inventory disappear from the house). The rest of the year I sell my "stuff" in a gallery in Beaufort, SC. Tally up more days spent each week immersed in my hobby.
And because there may be days when I run short of wood, I've begun painting with watercolor. It's a new challenge and is indeed challenging.
I never thought I had any artistic right brain, and I'm still doubtful when I look at my paintings. But it's enormous fun and the hours disappear when I paint.
Try it if you like, or try ballroom dancing, yoga, playing the violin, or helping build houses with Habitat for Humanity, or whatever floats your boat.
My medical school roommate and good friend, Cy Hopkins, shared with me this lovely parable: Long ago we packed our bags and boarded a high speed, fancy train called "Medicine."
It was a nonstop, fabulous ride for a long time. Now it's time to get off the train.
As you descend to the platform, think back to those few bags you left behind at the station when you boarded. Find and open them. You may be surprised at what plans you had in them.
Now is the time to try them out.
This article was authored by Peter C. Block, MD, FACC, Editor-in-Chief of Cardiology. He is a professor of medicine and cardiology at Emory University Hospital and School of Medicine in Atlanta, GA.
Keywords: ACC Publications, Cardiology Magazine, Retirement, Schools, Medical, Students, Medical, Teaching Rounds, Medicare, Consultants, COVID-19, Hobbies, Reading, Friends, Love
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