My group of nephrologists is trying to convince our 75-year-old colleague to retire from full-time clinical practice. I think he truly believes that the day he retires, his essence will be forcibly removed from his body, and he will cease to exist. He has told me, more than once, that he will be dead in less than a year if he is forced to stop being a physician. I envisioned this type of machismo was very old-school thinking, but may be not. Modern doctors strive for a better balance of work and life, but do you ever really stop being a physician?
We all have many titles in life. What happens when the title remains, but the interactions cease? I strive to add quality and not just quantity to the lives of my patients who need to start dialysis. I have type 1 diabetes and realize that their reality may someday be mine. I hope to retire young enough that I can still enjoy all life has to offer.
In nephrology, where we have not been filling fellowship training spots, we are failing to replace ourselves in the workforce. There will likely be a need for me to prolong my work life. When I think about stopping my medical practice, I think about the million ways to not do medicine: volunteering, teaching, reading, writing, relaxing. I love interacting and helping patients. I do not, however, always enjoy the structural, administrative, and financial barriers imposed by day-to-day practice. This has been my point to my senior partner; why not take the best parts of medicine and only do those things that add meaning and pleasure to your life?
But is my partner correct? Do we lose something when we retire? There is some evidence that waiting to retire may have some health benefits. In a 2019 Swedish study, it was suggested that working past age 65 was associated with better overall health, but one can certainly argue cause and effect in this type of observation. Not debatable is that the average age of American physicians is increasing. In a 2017 survey by CompHealth, doctors reported an average retirement age of 68 (vs 63 for all Americans), and only 32% said they looked forward to no longer working in medicine. Losing social interactions at work, feeling a loss of purpose, boredom, loneliness, and depression may provoke an identity crisis at the end of a physician’s career.
The ideal retirement means something different for every physician. However, it is clear that the valuable skills we acquire afford the opportunity to contribute long into our golden years. I hope that when I am 75, I have the choice to contribute (or not) as I see fit. There is purpose in being a doctor. The trap is when you assume all that you are is a doctor.
Brian Rifkin, MD, is a nephrologist.