Is it not better to quit with people asking why now, rather than why not?
One of my doctor colleagues recently took a bold (perhaps an outrageous) decision to step back from his extremely active clinical practice. He is not only an extremely capable and gifted doctor, but also immensely popular with his patients.
His decision surprised me. When I quizzed him for the reasons behind his decision, he professed convincingly, that everyone should be capable up of stepping back from professional commitments – voluntarily and at the time of their calling.
He thought very poorly of those, whom he termed as “professional hangers-on.” He did not want to be like them. He held a strong belief that many of them did not mentor juniors or, as is often the case, tried to thwart their growth. He added that if one had led a professionally active and fruitful life in his heydays, there was no harm in considering reducing or giving up one’s professional work voluntarily, rather than being forced to do so by circumstances or illness.
I was taken aback by his powerful reasoning. Do the general principles about retirement apply to doctors as well? Aren’t we – much like old wine – supposed to get better with age? Can the doctor in a doctor ever retire?
The Chutzpah Opinion
I have a group of close, like minded and similar aged friends. Even though none of us carry enough audacity to merit the name, we have chosen to christen ourselves The Chutzpah Group.
My wife and I are the only working doctors among this group. All others are retired professionals from different fields. Discussions in our group are wonderfully free flowing and frank. From politics to food, health to travel, grandchildren to technology, we indulge in active discussions about any topic under the sun.
The topic of whether a doctor should continue to work ceaselessly or can consider retirement at some point of his life, was debated animatedly during a recent, social meeting of this group.
I was surprised by the response from a senior member, when he incredulously asked me – “why would a doctor ever want to retire?” This question stayed with me.
Opinion among my colleagues
Cut to another end of the social spectrum. Many of my medico colleagues hold an equally strong and almost unquestionable belief that doctors should never retire. Medicine, they argue, is not merely a job. It is a calling, craft and an identity. You don’t simply hang up your stethoscope because you have reached a certain age.
So here are two completely different sets of people, arriving at the same conclusion. Doctors should continue practising until they are either incapable of doing so or until their final goodbye.
Why would a doctor want to retire?
Medicine – for good or bad – is an emotionally demanding profession. No doctor, however pragmatic or experienced, can remain entirely unaffected by the suffering he sees around him. Behind every diagnosis is a person, behind every procedure is anxiety, and behind every unexpected outcome is disappointment.
Add to this the pressures of patient expectations, socialmedia-induced stresses, the relentless demand to continually improve one’s performance and long working hours. Over decades, these pressures do take their toll.
There is no obvious finishing line. There is always another patient, another procedure, another paper to read, another technology to learn and another professional standard to chase. The treadmill simply keeps moving.
Therefore, wanting to retire is not necessarily a rejection of medicine. For many doctors, it may simply be a desire to wind down these stresses gradually, preferably in a graded manner over a period. It may be an attempt to step off the constantly ongoing hamsterwheel of professional life.
The reasons may differ. Some may want to pursue hobbies that they have postponed for decades. Others may want to travel, spend more time with family, contribute to social service, or simply discover what life looks like when it is no longer organised around the next patient.
The most fundamental reason, I think, is a desire to reclaim one’s life.
Why would a doctor never want to retire?
Paradoxically, the same stresses that doctors face throughout their professional lives are also the reasons that prevent them from retiring. It is a bit like Stockholm Syndrome – you are in love with your captor and its trappings!
The biggest fear may not be financial. Nor is it necessarily the loss of professional designation, status, or material comfort. It is a fear of social irrelevance.
What will I do if I retire? Will patients still seek me out? Will someone even be interested in talking to me if I am no longer a doctor? Will my colleagues remember me? Will my opinions still matter? Will people still call me for meetings and conferences? That, I suspect, is the actual fear.
Being looked for and needed is a constant and an inherent part of a doctor’s inner desire. They spend decades earning that. Someone is always asking for their opinion, seeking their advice, requesting their intervention or simply wanting them to be present. This gradually becomes intertwined with one’s sense of identity.
Retirement therefore threatens something far deeper than just employment. It threatens relevance.
This explains why some doctors continue practising long after they have achieved financial security and professional recognition. They are not necessarily working because they need the money. They are working because the people around them continue to say, in subtle and explicit ways, “we need you.” And who would willingly give up that feeling?
Should you or should you not retire?
Perhaps you should! Perhaps never! I am afraid, there is no universal answer.
Retirement from medicine should be considered only if one has something meaningful to retire to, rather than merely something to retire from. If you have alternate pursuits, interests and passions; if you have hobbies waiting patiently for your attention; if you have a social structure of friends and family that is not merely capable of, but actually craves your company and time, then retirement can be an extraordinarily liberating phase of life.
Yet, there is also a contradictory possibility. If you are the kind of doctor whose practice has occupied your entire time and energy; if professional interactions are your principal source of social engagement; if you genuinely enjoy meeting patients and colleagues – even when those interactions are occasionally intrusive – then I am afraid retirement may not be for you.
Is there a middle path?
Most of us do not actually want to retire. We might just want to work less. And that distinction may be the key. Retirement does not have to be a dramatic farewell. It could just mean winding down to fewer patients, fewer working days, selective practice, teaching, mentoring or simply keeping the parts of medicine that bring joy while surrendering those that bring exhaustion.
As a doctor, I consider myself fortunate that there are people around me who still want me to continue practising my professional craft. I am grateful for that relevance.
Yet I would like to believe that when the time eventually comes and I decide to retire, my patients, colleagues and friends will ask me, “why now” rather than “why not?” That might be the best definition of a fulfilling professional life – not being forced to retire because you are no longer wanted, but having the freedom to retire while you are still wanted.
This may also be due to my longing to savour the final years of my life, because as so wisely quoted – life is like a spool of thread, the nearer it gets to its end, the faster it rolls.
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Prof Hemant Madan is an Interventional Cardiologist and Programme Head, Cardiac Sciences for Narayana Health
