By Rod Moser, PA, PhD
I started clinical practice in 1973. It was a different (medical) world then. There was insurance, but most care was fee for service. Health Maintenance Organizations (HMOs) had just recently started to surface. Hospitalizations and emergency room visits were pricey in comparison with the cost of living, but not as astronomical as they are today. Office visits were relatively inexpensive. I was in my mid-20s and humbled by the complexities of medicine and the things I didn’t know. Now, nearly four decades later, I am still humbled by what I don’t know.
When I started to practice, it seemed like all of my colleagues were older than me. Since I started off in an internal medicine practice, most of my patients were older, too. I was the baby. As the years progressed, my patients and colleagues soon approached my own age. Now, many of my colleagues have retired or are retiring soon. Our patients are younger than us, and many of us have grand-patients. These are children of the children we used to care for.
I had lunch with two of my colleagues last week. One is 73 years old, another is 66. They are both retiring next year. I like hanging out with them, since I am only 61. I am the “baby” again. I am not planning on retiring for another four or five years. My wife is a PA and is semi-retiring in January after she turns 66. My colleagues, friends, and wife are all gracefully aging along beside me.
My 73-year-old friend said something that really made sense to me. He said that he does not know very many 85-year-olds who are actively traveling the world and having fun, so he figures that he may only have a small window to do what he had always planned to do when he retired. Granted, there are some active 85- and 90-year-olds out there, but not so many that we can live vicariously through their longevity.
This weekend, I spoke at a statewide medical convention. As I looked out at the room of faces, I was startled by how young they looked. Many were not even born when I started clinical practice. Our older colleagues in the organization have a sub-group called the “Dinos” – clinicians our own age who have shared our medical journey. We hang out in the lobby and talk about the old days while the younger clinicians are engaged in a swimming pool ruckus or wandering off to go dancing. One of my medical friends died last year of lung cancer. We all missed him at the Dino table.
We are all wondering what we will do when we decide to give up our full-time clinical practice. My 73-year-old friend wants to volunteer his time seeing patients at a free clinic; another wants to travel. I once covered a practice of an elderly pediatrician who could not retire. He finally passed away at home in his mid-90s, still going to the office three times a week. He had great-grand-patients!
It is a bit expensive to maintain your medical license, malpractice insurance, and continuing medical education requirements after you retire, but medical providers are reluctant to give it up. We see ourselves filling in from time to time when our younger colleagues have babies, go on vacation, or become ill. Some are looking forward to not being on call any more, but many will end up taking call for others (for a price). Some are planning to travel, assuming the world is safe enough to do so. Some are putting grandchildren through college, and believe it or not, some are worried that they will outlive their retirement savings and have to move in with their adult kids. We are all a bit worried about losing our mobility and fearing a life-ending health problem.
When I started with my particular group 13 years ago, I replaced a doctor who had a stroke at this desk. His recovery was slow. He ended up doing administrative work, but finally had to completely retire. He passed away a few years ago. Medical providers love their work, but no one wants to die at his or her desk.
A long-time friend of mine retired last year. The straw that broke the camel’s back was a nuisance malpractice suit. Although he did not do anything wrong, the case settled out of court for an obscene amount of money. He was so devastated by the outcome of this case that he just hung up his stethoscope. I saw him for dinner a week ago, and he has finally recovered and come to terms with this most difficult decision.
I guess medical providers are no different than others who finally reach retirement age. Some will be absolutely elated; others will be concerned about maintaining their lifestyle on retirement income and social security in this changing and volatile economy. We have all heard stories about vibrant and enthusiastic people who finally retire, only to die a few years later. We would all like to avoid getting older, but that would require dying now.