By: Michael A. Gisondi (@MikeGisondi)
Her Quote
“I’m not retiring, I’m rewiring!” said Dr. Rebecca Smith-Coggins, smiling, as she cheerfully characterized a significant professional milestone and a new chapter in her story. Her embrace of the word rewire – instead of retire –rang of optimism about the future and new opportunities to come. In using that specific word, she shared something quite personal with us: genuine excitement for what’s next and the joys it will bring. Not all physicians approach retirement this way. I found it inspirational.
It isn’t surprising for me to quote Dr. Smith-Coggins, tell stories about my times with her, or be inspired by her words. She is among my most cherished role models and mentors. She was also my residency program director back in the 1900s. I will be forever grateful for the opportunity she afforded me to train under her at Stanford. I have been learning from her ever since. This quote was no exception.
Their Good-byes
Dr. Smith-Coggins wasn’t my only mentor to recently retire. In fact, I bid farewell to a half dozen faculty members who were my attendings long ago, seemingly all at once… four in just the last 6 months.They taught me emergency medicine, which I then taught to my residents when I was a program director in Chicago.
Returning to Stanford after 14 years gave me the opportunity to learn from these newly-minted retirees twice: first as a resident early in their careers and then again as the sage senior faculty members they had become. I’m a sentimental guy, so spending the last several years with them before their retirements was special.
All that said, the mass exodus of my role models from my day-to-day life struck me. Perhaps because they exited in such quick succession? (Spacing it out a bit would have been nice.). As such, I’ve spent a great deal of time reflecting on retirement this past year…not so much about my own retirement, but rather the convention of physician retirement in general. And I have some thoughts…
My Opinion
I don’t think we do retirement well in medicine. If there is a playbook for how to do it well, I am unaware, and my guess is that it is sorely insufficient.
Yes, there are employer-based retirement plans and financial advisors to guide you. That’s not what I am talking about. It’s all the rest.
Retirement from medicine is illogically organized, messy, and intimate.
Illogically organized
- What of our most seasoned physicians?
- Do they have enough career satisfaction to prevent an early exit from burnout?
- Do they follow dynamic and enriching career paths until they are 65 years-old?
- No, many don’t.
Messy
- What of those physicians who don’t have the physicality for the profession anymore?
- What happens when they can’t generate the same RVUs as their 40 year-old colleagues?
- What happens when they slow?
- Do they depreciate in value?
- They do, within many organizations.
Intimate
- And what of the professional identities that they spent so many years cultivating?
- Do they suddenly deidentify?
- How long does it take for them to go from physician to former physician or… retiree?
- In an instant, officially. Never, say many, which is discordant with their new lives.
I’m reminded of a colleague who recently retired from her clinical practice. She described her new routine: she still wakes up at 5:00am, as she did for 30 years, but now to start a puzzle at her kitchen table. And at 5:03, she often throws that puzzle across the room. She’s bored.
Perhaps I am biased by my own specialty, emergency medicine. We are still the new kids of the profession, and we are just seeing the first wave of emergency physicians reaching retirement age. And we don’t know what to do with them. Most emergency physicians simply decrease their clinical hours slowly over years, then they take no more night shifts, eventually they switch to part-time, and then one day they are no longer on the schedule. How long before someone notices? Not the most enriching path. Our field needs to do better with those nearing the end of their careers.
Admittedly, I don’t have a good sense for how other specialties do retirement, but I can’t help but wonder if they could do better, too.
Her Final Lesson
I carefully watched the ways in which Dr. Smith-Coggins retired, and she went out on top. Many don’t. Perhaps she read the playbook? Wrote the playbook? She taught me how to begin my medical career, and I am fairly certain that she just showed me how to end it with grace. Eventually.
About the author: Michael A. Gisondi, MD is an emergency physician and medical education researcher living in Palo Alto, CA, USA. He is Professor and Vice Chair of Education in the Department of Emergency Medicine at Stanford University, and an Assistant Dean for Academic Advising at Stanford School of Medicine. X: @MikeGisondi Threads: mikegisondi
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