Happy Thanksgiving

Today is Thanksgiving, a time when we all think about what we are thankful for. It is unfortunate that we are not thankful every day of the year, since giving thanks does wonders to brighten our disposition. As Thanksgiving approached, I picked up the ACS Surgery News and found an article written by one of my mentors from my medical school days at Oregon Health and Science University (OHSU). I began to reminisce and it dawned on me just how thankful I was for all the mentors who guided me through the years.

This mentor, Dr. Karen E. Deveney, was an important component of the training I received in medical school. She loved to teach and was always so supportive of her residents and students, even when we screwed up. She was an example of the kind of doctor we all wanted to become.

Dr. Deveney’s article, “Hanging Up The Scalpel,” was in the September edition of the ACS Surgery News. This title really caught my eye as I had just hung up my scalpel earlier in the year. Her article discussed how we approach competency at the end of our career, as no one wants to be the doctor who is asked to stop working for the safety of their patients. How do we know when it’s time to quit? She made many good points about how to determine when our operating days should come to an end. Since some surgeons never want to stop operating, this becomes a very important question.

The opening sentence was powerful: The decision to stop practicing surgery is a monumental one when you have been a surgeon for almost 40 years, have loved operating, and have defined yourself by the word “surgeon.” I went through this struggle last February as I hung up my scalpel and wondered how I would manage mentally after I stopped operating. Since I slowed down my practice gradually, filling my newfound time with a new passion, leaving my medical career eventually seemed natural. Taking my skills and applied them in another way enabled me to still have a sense of purpose. I think many surgeons quit without a game plan for their future. Going from prominent surgeon to mediocre golf partner can be quite a blow to one’s self worth.

Dr. Deveney discussed her “fear of becoming irrelevant and unproductive.” She took her skills and found new ways to utilize them. She is writing and editing for a medical journal, teaching students and residents in the surgical skills lab and giving advice on difficult cases to her colleagues in the surgery department. There are contributions she can make with her new found time that the younger surgeons just don’t have time to do with their busy schedules. She continues to have a purpose, even without her scalpel. She hardly seems retired but I’m sure her load is greatly reduced now.

We all need to have a purpose, even in retirement. Most surgeons don’t want to be “retired,” but they would like to decrease their work load. Being a surgeon is a tough job. Finding a new purpose is key to a happy post scalpel life. We have so many other skills to offer besides our scalpel.

Dr. Deveney talked about noticing her performance changes as she aged. She is a runner and has watched her speed decline slowly as time marched on. No one can do the things at age 70 that they were capable of at age 25. She noted her running pace has dropped over the last 40 years from a 7 minute mile to a 14 minute mile. These changes happen gradually and are not noticed day to day, but look back 40 years and the decline is evident.

This decline is evident in other areas as well; manual dexterity, reflexes, recovery, and other important aspects in a busy surgeon’s life. To compensate, we need to slow down our pace. We slow down by not taking call, cutting out the long difficult cases and doing more assisting. These are also ways we can ease out of our medical practice.

My experience of going through this period of winding down a career in surgery was what inspired me to write The Doctors Guide to Smart Career Alternative and Retirement. Every one of us will come to the point where we will quit practicing medicine. When that time comes, there are a lot of things to consider. You can modify your practice, you can change to a different career or you can actually retire altogether.

An important thing to consider is to bow out before you reach the point where someone else is asking for you to retire. If you are hearing someone say your skills are no longer up to snuff, they are usually right and you need to listen to them. That is a hard conversation to have and once they get the courage to bring it up, it was probably long overdue. Consider retiring before that happens.

Take careful assessment of your skills as you age. We all want to believe our skills will remain unchanged forever, but sadly, that is not the case. One day you will wake up to realize that you now run a 14 minute mile. You aren’t in the same shape that you were in 40, 30 or even 20 years ago.

Before you pull down your shingle, get a copy of my book and consider your options. It is very important to plan your transition into your post scalpel days so you make a decision you will feel good about for the rest of your life. You might even do like I did and avoid the word retired and use repurposed instead.

A special thanks to all the doctors who mentored me along the way, during college, medical school, residency and the twenty three years of my practice. I avoided many struggles and lived a much better life because of your guidance.

Thank you and have a Happy Thanksgiving.

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