Many people have asked me how I knew it was the right time to retire. They are struggling with the decision and are afraid to pull the trigger too soon. Retiring from medicine is almost a final move as it is very difficult to return after being away for a period of time. I haven’t operated on a patient for more than four years now, so no one would let me just return to my old practice, if I decided I had made a mistake by retiring.
I understand the apprehension in those asking me about this important decision because I felt the same nervousness when I was considering retiring. I have not regretted my decision and have not missed medicine. There were, however, a few things I considered and put into place before I made the move. If I would have skipped one of them, I might have regretted the decision.
Let’s walk through my decision making and planning process and see how I went about this move. If you incorporate these things, you should have a smooth transition into your retirement years.
Finances
The first thing I put in place was financial security. I had a plan since medical school to be financially independent by age 50 and able to retire. I landed at this right on time. My criteria for financial independence was twofold:
First: I wanted the cash flow from my rental real estate properties to exceed my retirement living expenses. This way I could continue to live my current lifestyle without ever touching the money in my tax deferred retirement plans, 401(k), IRA….. This is also income that would continue to increase with inflation as rents go up over time. I would be living on a rising income, not a fixed income.
Second: I wanted to have a balance in excess of one million dollars in my tax deferred retirement accounts that are invested 100% in stock mutual funds. This would be extra money for any big things I wanted to buy in my retirement years. Using the 4% rule, I could safely pull out $40,000+ every year if I wanted something extra. But since I wouldn’t need any of this money at all, in reality, I could take out however much I wanted at any time for big purchases.
Having both of these in place when I turned 50 was a great culmination I set in motion years before. I guess it proves that retirement math works.
Even though the finances were there, and my wife kept assuring me we would be fine if I quit working, I still wondered if I had enough. That is one feeling that will not go away until after you take the leap and are retired for a few years. Now I feel very comfortable with the amount I have saved, and I don’t worry about overspending anymore. In fact, I have loosened up the purse strings even more and increased my giving and spending.
Purpose
The next thing I wanted in place before I quit practicing medicine was a new purpose. If one retires with no clear plan as to what to do with all their free time, there is a big risk of becoming bored and feeling the need to return to work.
I did a lot of thinking about what I would do in my retirement years. I settled in on teaching physicians other high income professionals about personal finance. I started a book series and a blog. The thing I have liked the most in my new purpose is coaching other physicians to have a more fulfilling life and a more secure financial situation.
I became a Certified High Performance Coach to help physicians reach the next level at whatever they want to accomplish and to decrease burnout. I started a financial makeover coaching program to help doctors get out of debt and plan for retirement. I also started doing real estate evaluations for people buying their first rental investment.
All of these things create a purpose for me so I still feel useful during retirement. They also can be done while I am traveling. Working a few hours a week on my own time schedule is very rewarding. The few hours I spend on these things each week make me feel useful and productive without giving me a full time job when I am supposed to be retired.
If I had just stopped practicing medicine with no new purpose, I think I would have gotten bored and wondered if I had made the right decision.
Winding down from full speed
Another thing I worried about was dropping from a full practice to nothing. As a type A personality, I didn’t think I would do well if I just quit one day. Going from 60 hours a week to nothing is a big jump.
I decided to cut back my hours slowly. My medical partnership did not have a provision for working part time. So to cut back, I needed to leave my twenty year practice and start working locums half time. This gave me a chance to slowly decrease my work hours to ease into retirement. I put everything I learned about locums into an online course so others can begin working in locums without reinventing the wheel.
I started out working two weeks a month covering the emergency department and inpatients at critical access hospitals that provided a very light work schedule for me. I was essentially a general surgery hospitalist in a low volume hospital. I saw an average of one new patient a day. My previous partners also hired me as a locums to take call one weekend a month, so after I retired their call burden did not increase. Covering my old practice gave me an average of five patients a day when I was on call.
Over time I started decreasing the hours. After two years, my prior partners started getting paid to take call, so they no longer wanted me to take call anymore. A year later a part time doctor was hired at one of the critical access hospitals I was working at, so I wasn’t needed there any longer. I was then down to working one week a month at one critical access hospital.
Two and a half years into my slowing schedule, I noticed I was losing my edge as a surgeon. I was not busy enough to keep sharp. I found myself thinking about the next steps in a surgical case that I used to do automatically. I realized I had to make a choice; either set the ball in motion to stop practicing soon or increase my surgical volume to maintain my skills.
Book wins award
While I was debating what to do about maintaining my surgical skills, I went to the Idaho Author Awards Ceremony where I was awarded Non-Fiction book of the year for my first book, The Doctors Guide to Starting Your Practice/Career Right.
That was a tipping point for me. If my writing was getting awards, then I was ready to move to the next phase of my life.
I had the money, I had a purpose, I was working only a few hours a month (one patient a day only one week a month) and I was feeling like my skills were slipping. All my ducks were in a row to pull the trigger on retirement.
After returning home from the awards ceremony, I submitted my 90-day resignation as per my locums contract with the hospital. I was on the call schedule for my final three months after which I would retire from medicine.
At the end of my last day of call in February of 2017, I turned in my pager, signed out my patients to the doctor on call, and left the hospital for the last time to Kathy Mattea’s song, “Eighteen Wheels and a Dozen Roses”. I was retired!
I felt quite a relief. Since I still had a purpose as an author, I like to say I didn’t retire, I repurposed. I even make a little money with my new purpose that adds to my retirement funds. I didn’t count on that but it was a nice surprise.
Today I can write when I want and play when I want. The world is about to open up to travel now that people are vaccinated so we will be gallivanting around again soon. We were traveling more than half the time before COVID hit.
I love my new life, especially the part about getting up whenever I feel like.
Before you think about retiring, be sure to have enough money, a new purpose, and the desire to no longer practice medicine. If you have all these, you will have a great time in your retirement.
Before you make the move, be sure to read The Doctors Guide to Smart Career Alternatives and Retirement to further help you in your transition. Best of luck in your retirement years.
I enjoyed the gamut of stories and responses. I am an 88 year old certified family practitioner working in a 3 doctor office practice for the past 60 years in a middle class neighbor-hood adjacent to Los Angeles. I relished it all even as it consumed me totally. I was an unmarried 28 year old who took over a small solo medical practice and was totally committed to medicine and patient care. I used the local hospital and consultants where I had trained and felt comfortable with the support I received. My commitment was rewarded by the patient responses and a fast growing and soon 3-doc successful practice. I have seen much since the days of 1960. I practiced in and experienced all areas of medicine and surgery. I married at age 35, have a supportive wife, 2 daughters, one a physician, and grand children. I made the necessary financial real estate investments in my area now worth multiples of seven figures and could have retired years ago. The patient care is now done by my associates but I continue to come to the office each A.M. Enough said, I guess I am still committed.
A few thoughts …
Cory – thank you for your post and your blog in general! I have gained many insights from you and others in the area of medicine and finance. To your point about being able to accumulate sufficient financial resources on a relatively lower salary, I spent 25 years in military medicine and only topped $200K in income in my last three years. Despite living in a high cost area, sending two kids to private schools and halving my net worth at retirement (due to divorce), I have rebuilt my net worth to over the $2 million mark. It can be done, it just takes planning, budgeting and discipline!
Nathan – Like you, I feel that my vocation as a Pediatric radiologist is a rewarding privilege … I actually choose to work more hours now than at almost any time since completing fellowship and I take vacation from my full time job to do locums work. It is difficult to imagine stepping away and I love teaching the next generation of radiologists. Further, I am actively pursuing more challenging cases such as interventional procedures as I move into my late 50’s.
Most importantly, my wife and I have four kids under 16 and still manage to find time to be together at home, take vacations and actively plan for our futures!
Dr. Bill,
Thanks for showing us it can be done.
I went a different route. I am a family medicine trained physician. I am currently 53. I worked in rural Iowa and was a “full spectrum doc”. I currently reside in a larger city in Texas. I started to dislike the fact that to make more I had to see more patients to cover 60% to 65% overhead. At some point I realized that seeing 30 or more patients a day was not causing a windfall of compensation and quality of care was suffering. So I went over to the dark side and worked in a free standing ER. Great compensation, good hours and I felt terrible not taking proper care of patients. I could write volumes about the ER and why they are terrible for modern health care.
I needed to get back to high quality primary care medicine. I needed to make money. I need to fulfill my desire to be a good doctor.
I went solo. I only perform house calls.
My overhead is now 5 to 7 %. I bill at higher rates than traditional primary care and see half as many patients. I spend 1 hour with patients and never look at my watch. I have never been happier or more appreciative of my patients. I am so small insurance companies hardly ever bother me with burdensome requests for CQI data. I practice medicine like it is 1930. I still make referrals and do all a “regular office” does including dermatology, psychiatry, internal medicine and ortho. I have a black bag and tackle boxes full of my tools and supplies.
I am enjoying my career on my terms. I know this sounds all Norman Rockwell like but think about the business model and how this achieves financial success while checking off all those boxes we would like to have in our lives. Some say this only applies to primary care. I feel that any physician that had an intern year and desire to learn just a bit more can easily master the knowledge to be a good ” house call doctor”.
Nice Peter, I have been doing the exact same thing in rural central OR for the last 7 years. Entirely housecalls, concierge style Internal med. So I charge a yearly fee on top of billing insurance, see 4 people per day avg, have 2 staff, much more free time than I used to have although I am on call 24/7, but an hour with ea pt, and much needed time to contemplate their problems as I have very complicated chronic disease patients. But, wow what a difference in practice from the old grind. Making a fair amt more income as well.
Thanks for the candid posts from so many that generously shared their experience and their hearts. I read the entire thread and wholly agree that finding purpose in retirement is infinitely harder than finding the financial solution for retirement.
For those contemplating retirement, as Cory said, you will not understand if you made a mistake till you actually retire: Be prepared to not miss what you think you will (e.g. clinical practice) and to miss greatly what you never even considered (e.g. the ordinary interactions with colleagues, front desk workers, OR staff, etc). Be prepared for a new calculus to your family life, especially with your spouse. As one medical TV sitcom said “If you don’t go home now, you will have no home to go to”. So if you’ve neglected your family (esp. your spouse) for the past several decades, you’ll now find that out in retirement (you will be reminded every day) and wish you’d stayed in the office!
Truth is, you just cannot find peace in medicine, with its unique brew of stress, liability, schedule, and overstimulation! You have unwittingly and incrementally surrendered your personal interests, your family life, and most of all your peace of mind to medicine for decades. The best aspect of retirement for me is the simple experience of having no schedule, no overhanging liability, no adminstrative control…Now, I have time to just think, smell the air, and “be”. Oh, what godly peace retirement is!
This past year I went from part time to fulltime work again. I’m happy to hear from those who retired in their 70’s or later because at 67 I’m enjoying work and can’t imagine retiring. I feel very fortunate to be able to work as a consultant to a mental health clinic and work from home. It’s made all the difference.
Nathan Strahl
nathan_strahl@yahoo.com
Cory,
Excellent article. I just retired at 78. Love my Orthopedic Surgery specialty. I wanted to retired at 50, then 55, 60, 65, 70, 75. It was interesting because from a financial point of view I could have, but I was so interested in what I was doing that I postponed many times. I did work at a trauma center, then private practice for almost 30 years, finally I went to work at the local VAH where they needed a general Ortho surgeon that did joint replacement as well. I did stop doing surgeries at 76, when I felt I was doing minor mistakes that no one noticed but me. I did not want to make a major one that would compromise the outcome of the surgery. The chief of surgery understood and I transitioned to clinic only work 3 times a week and finally twice a week until during covid the clinic was closed. I did work with many residents and most of them did not know about personal finance. That leads to live like a millionaire when you are not, and down the road that makes very difficult to retire comfortable when you want. The starting salary in CA for a FP is about $220,000. If one lives within your means and save and invest wisely, you will be OK when you decide to retire. But don’t do it too soon if you like what you do.
Serg, you have a great story. I’m glad you had such a long and happy career. Thanks for sharing it.
Great article.
What I would like to know is how you were able to purchase real estate with no money down.
As for living frugal, it may be difficult in places like NYC where cost of living is high with a glut of docs. Relative income lower than the south or Midwest.
So not realistic for many of us and especially the non procedural specialties.
Chin, How to buy property with no money down is tough to explain in this space. I did cover it a bit in my book on real estate. Essentially you borrow 100% of the purchase price. You might get 70% from the owner carrying the note and 30% as a second mortgage on another property, as an example. It is realistic no matter what the cost of living is where you live. Just always live on less than you make and you have something left to save. If you think you can’t make it happen in some place like New York, ask yourself how the school teachers there are living in this area on an income much less than yours. If they can live on much less than half of what you make, you still have a lot of wiggle room.
i am a Board Certified OBGYN, who was in solo-private practice from 1977-2004….. at age 59.5 my hands, back and knees had documented osteoarthritis….. my body was telling me that i had to stop working…. within 4 days of listening to my aches and pains, i called a colleague and asked him if he wanted my practice that had over 8k active patients…. free of charge!!!!…. the only two requirements: (1) my duties ended at 12 noon on Friday and, (2) he was to be the sole caretaker of all my active and inactive charts….. he gladly agreed and came to my office the next day to sign the contract (witnessed by two of my employees) that i had written the night before….. at 12 noon on Friday, I WAS FREE AT LAST!!!!….. i agree that (1)economics play a major role in long/short term planning…. lifestyles change and cost $$$… inflation occurs and cost $$$$…. additional, unplanned things cost $$$…. (2) additional free time after retirement must be enjoyed….. keep your mind open to the vast possibilities besides travelling, donation of extra time to charities, etc…. consider learning how to play bridge, canasta, etc…. auditing classes at a local college is fulfilling and interesting…. starting an autograph collection (book, sports memoribilia, etc) can be fruitful…. unfortunately, my severe osteoarthritis caused me to adapt…. (3) one other thing to keep in mind before you consider retiring: you have to be ready to realize that you will not be the boss, the”go-to guy”, the “big cheese” anymore….. Remember, besides being economically fit before you retire, the psychology of retirement is equally as important….
Dear Cory. Thanks for your insightful comments on a subject every Doc needs to eventually go through. It is very scary and anxiety producing. I worked for 43 years in primary care, then got certified in obesity and worked for 4 more years until covid forced me out in one day. I was not ready. I don’t think I would have ever retired even though I was burned out. I felt financially insecure. It was only when I was forced not to work that I realized how stressful it was and how much I hated it. When my hospital reopened I chose not to go back. We have been living fine on social security by leading a simple life. I do have 1 million plus in investments but haven’t had to use any. I also have 2 grandkids nearby that I spend time with and enjoying cooking for the extended family. By living a contemplative and simple life I am not bored and find purpose in writing and in caring for the family who are all busy and stressed due to working from home with kids. There is so much joy in being peaceful. I also don’t feel guilty because I worked til 75 plus! Good luck to all of you and you don’t need all the money you think you do!
Kristin, thanks for your words. I found I had more money than I thought I needed. I am also enjoying babysitting my grandson 1 1/2 days a week. I couldn’t do that if I was still working full time.
Many (?most) retirement options have a recurrent theme-invest in real estate as an income source. I apparently am the only physician who cannot stand the thought of being a land lord. I can’t even keep my own lawn mowed or up keep on my own house maintained, much less another property. I know those who do it probably hire someone, but it seems that would take out most of the income. I would rather rent if my wife would let me. She won’t…
Just another perspective. Working till my wife and I qualify for Medicare is my “plan.” Maybe with some locums to keep me busy or as a bridge.
Vanjr, lots of doc don’t want to be a landlord. You can invest in real estate without doing the work yourself. I currently do none of the work and there is plenty of money left over to live on. For some reason many people think that if you owe rental real estate, you have to do all the work. I bet you didn’t answer the phones in your practice. That is why I made the course The Doctors Guide to Automating Your Real Estate Investments. The real estate can take care of itself without my input.
I had sold my practice 13 months prior to COVID and having a one year contract allowed me to retire. The COVID time at home was a bit boring, at times, but allowed me to gently transition to a different life. However, at 63, I felt as I had more gas in the tank, and as such, I returned back to practice, part-time, as an Independent Contractor. This has given me much more purpose in my day-to-day life, and has keep my hand in what is my professional life’s ambition as a clinical Dermatologist — I love seeing patients; working 2 days a week !!
I too had plans to retire at 50. I had a Navy HPSP scholarship that reduced my debt from med school. I invested in the 401K program as a resident and also invested in stocks, mostly tech. Having 3 kids and investing in their private schooling, I didn’t reach my goal of 50 but at 52 I decided to leave my Anesthesia partnership of 20 years. I started an office-based mobile anesthesia practice where I work human hours with no call and no weekends and haven’t looked back.
Your article describes a path that I myself followed very closely to retirement. I also used locum tenens as a transition, with that having the extra benefit of being home 24/7 when not working, This was more congruent with my time flow when I retired than it would have been if I went from a (nominally) 8-hour day to suddenly being at home full time. I would have done locums a year or two longer had I not also noticed my skills deteriorating to a point below my own personal standard of care. My difference was that I did not develop an alternative source of income, but instead built a large enough retirement fund that the earnings generally equal the amount I withdraw, so I have thus far had no anxiety about running out of money.
Living a lifestyle well below what my income would have supported for most of my life was helpful in building the size of my retirement fund and after-tax savings, as it is in maintaining that same style in retirement. In mid-career, I had 3 years of such a huge income that, even with saving half, I could live the “high life”, which was fun while it lasted, but wasn’t really missed when it was over. My retirement was only about 1 1/2 years “early”, so both age and, now, health problems further limit what my wife and I can do together, in terms of expensive things, further limiting expenses. I still volunteer at church and with teaching outside the medical field, and am happy with what I am still able to do, rather than mourning over what I can no longer do- an attitude that I believe makes me happy in retirement no matter what my situation.
i worked 20 yrs, 24/7 coverage of pulm/crit care/sleep in 60 doc multi-spec group in NY
made 5 million $; quit & work 15 yrs LT& partime while in Alaska, Hawaii, American Samoa, Slovenia & SoCal;also coached 40 youth baseball teams in the spare time.
realized that clinical medicine is more fun than work so PT medicine is a paying hobby & this is how a “lifer” ends up( by gradually lowering the work load, eliminate administrative duties,, mentor the new docs,no night call since 50 yo
I enjoyed reading your article, but soon remembered that there is a large percentage of physicians who are engaged in primary care and do not generate large incomes from procedures. For those individuals who are raising a family, saving for college expenses, paying off educational debt, and working long hours, the prospect of developing rental properties and a large nest egg can be daunting. For these physicians, retirement in their early fifties is a fantasy.
Working Hard Doc, I never made near the money everyone thinks I made. People often assume I could retire at 54 because I made the “big bucks” as a surgeon. It can be done on a primary care salary. I bought all my real estate with no money down, so any doctor can do that, even today. I worked in a depressed area and took a lot of vacation time (unpaid 8-12 weeks a year) which kept my income lower than average. It’s not about how much money you make, it’s about how much of it you keep, what you do with it, and how you invest it. I was maxing out my retirement plan as a resident and I couldn’t talk the other residents into doing it also. We all made the exact same income, but somehow I was the only one who could save any of it. The rest thought they needed to spend all of their earnings now and they would start saving later. The average Primary care doc makes $200,000 a year. I think that is about three times the average American household. They should do well on that. Thanks for your comment. I hope I will be able to teach those primary care doctors that it is possible for them to do this also and not just a fantasy.
I think you hit the nail right on the head. There is always room to save for a physician, but also need to invest the savings wisely in order to save enough to retire comfortably. It is amazing how similar paths we’ve followed, including the real estate part. I’m not a surgeon, I am a pediatrician, retired at 65, two years ago.
I would recommend every physician to read your books if they don’t want to work all their lives.
What about researching and writing on staying in practice as one ages? Currently, at age 76, I plan to retire only on one of three days: 1) I am carried out horizontally, 2) The chief of surgery gently places his or her hand on my shoulder and suggests retirement, or 3) It stops being fun. I am still healthy, love what I do, am in solo practice but with great coverage, and travel several weeks a year. Obviously, things will change with time. Suggestions would be appreciated on topics such as self assessing when I need to retire, financial security, best ways to slow down, and planning for possible mandatory retirement.
Jerry you bring up a good point. I do a high performance coaching program that helps doctors refine their practice so they like it better and it is tolerated better so they can continue to practice to a ripe old age. Maybe you can do a guest article about how you have modified your practice as you age. Thanks for doing what you do.
Love this, That’s how I want to do it.
Well, without even reading your book we financially followed your rules. So that shouldn’t be a problem. After 20 years of solo practice in Pain Management and 10 years prior working for others I fortuitously sold my practice 3 months prior to Covid lockdown and telemedicine. Suddenly my travel plans were out the window and there was lots of time. My natural inclination was to fill it….but why did I feel the need to do that? At 61 I’d worked 30 years post residency without a break outside of 2 week vacations and three 2 month maternity leaves. It was time to take stock in my varied interests, like running, gardening and photography and now a return to travel, clean out the accumulated mess of life in this house and spend time with my husband who is 13 years older than me. Because of this single factor I always knew I had to push hard and would get to cut out early. He will be 75 at then end of this year. Things can happen. My purpose is taking care of myself so that I will be able to take care of him if needed. I thought I would miss medicine more. I enjoyed my patients and my work tremendously. But it was time for the next phase of life, which I am trying to let unfold naturally and with curiosity about what could be around the next corner. It’s tough not to try and fill in every moment, steer myself in a certain direction and try and validate myself with my purpose. But for right now, just 16 months into retirement I don’t want to “need” that definition yet. It may come and I will be ready, or it may not and I will continue to enjoy the day to day wonder that nature and life present me….and maybe write some more poems about…in my mind, get back to the piano, or finally learn to successfully operate all the tech gadgets I still ask my kids to help me with……
I like your post. It is amazing to me all the accoutrements of life that pass us by while being a busy physician. Enjoy your husband and your children and continue to realize that “just being” is pretty special in it’s own way.
My biggest decision maker when I decided it was time to retire was my wife of 45 years. I had either been in training or in a very very OB practice for the entirety of our marriage. Had I been alone I would have continued practicing medicine till I dropped dead. Four years into retirement I am happy every day to spend time with wife and any other diversion is just icing on the cake.
Great review.
I suspect for most the ‘financial’ part is easily accomplished. The ‘purpose’ , not to difficult once one’s interests are contemplated. But that ‘what to do if I made a mistake’ part is the worst. I accomplished it easily since my ‘purpose’ kept me intellectually in the medical arena. I stayed on at my hospital system as administrator in the research office; took and passed the CIP exam (Certified IRB professional) ; became a voting member of the IRB and Chair or Co-Chair of a subcommittees.
As a retired interventional cardiologist I learned more about AIDS, maternal/fetal health, and cancer than I ever forgot in my 30 yrs of specialty practice. For me, that covered all bases until I stopped at age 67.
DAVE
David, It sounds like you had a fulfilling career.
I struggle with early retirement because there is a tremendous shortage of surgeons in almost every field AND we took a spot in med school and residency that could have gone to someone who may have worked 30-40 years or longer. Is 20 years really giving back enough time for everything that was put into your education and training? I dont know the answer but I think about it a lot. I’m at year 27 post fellowship (vascular surgery) have some health problems but still at the top of my game surgically. I could retire financially anytime but again ….is it the right thing to do when I am at the top of my game and there is a tremendous need?
Mark, I struggled with that question as well. I never came up with an answer as to how long was long enough to work as a doctor before you have “given enough” to society. The way I see it, I’m now helping other doctors have a nicer practice and life so they can work longer and not quit because they were burned out. We will all retire at some point. There will always be someone who worked longer. I don’t have an answer, but I was ready to pull the trigger after 23 years of practice. Hope you find your sweet spot for retirement.
i have always felt this was an interesting point …there was alot invested in us…not just by ourselves but by all around us govt ,societal expectations,etc. my feeling 30+ years is the minimum…the plus is the bonus we give to society…plus gets us near the medicare age and why pay for healthcare when we never had to.
You stuck the landing. Congrats!
Dan
Cory,
Your article was spot on. I am a little older than you at 64, but I am doing all the things that you are. The nest egg, the rental income and soon social security. I am writing a book myself. It is about having less stress. Writing a book is like learning a whole new profession. And there is a lot to learn. Maybe we could chat about the process of writing and marketing a book as a doctor.
Gary
Gary, Glad things are working out well for you. Books are a big undertaking. Best of luck.
Thanks for this excellent article. Glad you’re thriving.
Cory,
Sounds like you have all the bases (financial, purpose, family) covered!
Great example how “pre-retirement” physicians can benefit from locum tenens as a bridge to retirement.
Best wishes,
Andrew Wilner, Thank you.
Thank you for sharing your experience with other physicians.
I find myself at the age of 52, thinking more and more about semi retirement. I do feel the burn out, and the effects of an all “nighter” in the ER, although my skills remain sharp and my genuine interest in helping patients still the same.
I did plan well for retirement, starting after medical school and into my early residency years having been in practice for 25+ years now, and having done some very smart investments, including few dozens rental properties, retirement plans etc,… thanks to a lot of help from fellow physicians. However the idea of finding a purpose is still eluding me and remains scary. How to cut all the income you bring in right now, and what if I would regret my decision?
I do plan on seeing and working with my nursing home patients, having purchased few nursing homes along the way, and I consider this to be my retirement plan, to give me the purpose and some extra cash to go along the way. Dropping from over 100 h/w to 20-40 h/w is a scary thought, but I feel now it can be done, just as you shared with us.
Thank you again, I’ll be buying your book on retirement, and I appreciate your input.
Brmcdoc, thanks for sharing your story. It is a tough decision because it is hard to go back if you change your mind. Hope my book helps you choose the right time to pull the trigger.
Twenty seven years ago, I retired and never looked back again. That is not to say that I have not missed patient contact and surgical procedures as a neurosurgeon on occasions. I have enjoyed missing the changes in the demographics of a private practice. The decision was made when the utilization person with which I spoke, could not spell “carotid endarterectomy”. That made the exit relatively simple.
Vance Roy, Glad you have enjoyed your retirement.
For sharing these details about your transition away from medicine. I wish you lots of success and good times in your new life. It sounds like you have a lot to fill your hours.
Outstanding article. Far too many people in my opinion are concerned with the financial part and less so on the more important issues of purpose and transitioning. As an otolaryngologist, I also am particularly sensitive to slowing down as I have felt my skills dulled temporarily with a 1 month break between jobs. It seems for a procedural-based field that there can be less uncertainty because I don’t see a viable path back if I were to try retirement and not like it. Plus, a large part of my purpose involves volunteering my surgical skills now and for as long as I am able … so my fate is sealed! I’ll probably keep going as long as I am able and feel my skills are sharp, but love knowing I could walk away tomorrow and at least have the financial part covered. Again, I love your writing, your perspective, and appreciate what you bring.
It’s good you made the move. I felt the same way where I enjoyed writing way more than I enjoyed investment banking. And when the lightbulb moment turned on where I can negotiate a severance and walk away with multiple six figures, I thought it was time to go in 2012, even though I was only 34.
But after about a year and a half of early retirement, travel, and so forth, I decided to focus more on Financial Samurai and on family.
But I’m ready to re-retire this year and live it up again!
Sam
Financial Samurai, I found that I tend to over do things. Start travelling so much that it gets old and then stay home for a while until I miss travelling and then start travelling so much it gets old. I need to find the right balance. Now that I have my first grandchild in town, I feel less urge to travel and more urge to be here and help raise him. We babysit 1 1/2 days each week and that is a joy I would not have had if I was still working full time.
Cory:
As a fellow surgeon contemplating my early retirement soon, I really appreciate your sharing your story and your insights.
I read your comments about “losing your edge” as a surgeon with great interest. This is an area with which I struggle in this decision about cutting back. I am hoping to go part time soon and focus on only the more complex part of my practice (which I enjoy the most and has the greatest impact) which I only perform a small percentage of the time anyway. I am thinking that if I do the same amount of these complex cases as a part time surgeon as I do as a full time surgeon now, I should still be able to practice at a high level longer. I also believe going part time will decrease my overall burnout which would benefit all aspects of my practice.
I am curious on your comments regarding the balance of improving your skills/performance due to decreasing burnout, but maybe losing your “edge “ due to less overall surgical cases? Also, how much do you think simple aging affected your surgical skills at the same time?
Thanks for what you do!
Introvert Investor MD, When I cut back to emergency surgery only, Even though my overall case numbers went down, those cases were concentrated in only a few procedures. This kept my skills in those procedures. I no longer did any surgery for some things like breast and thyroid. So my skills in the areas I no longer used dropped. I don’t think age played any part in my case. I began to cut back at age 50 and retired at age 54. I was not as agile as I was when I was 30 but I don’t think I was old enough for that to make a difference. I did notice that in my 50s I had a harder time recovering form an all nighter though. You don’t need to cut back very much to decrease burnout, so I don’t think that will be the cause of losing your edge. Getting an assistant, stopping work an hour earlier to be home for dinner, eliminating some cases you don’t like to do, and taking a day off during the week will go a long way towards combating burnout without dropping your case load enough to lose your edge. When I thought I was losing my edge, I was down to about 6 new patients a month as I worked only one week a month in a small hospital that didn’t take trauma for the last several months of my career. That is not enough cases to stay sharp for long. Best of luck in picking your retirement date.
Excellent post.
I am at the point where I am struggling with the decision of if I really have enough to retire or not. I probably could walk away fine right now at 50 but my original plan was wait till 53 and my daughter graduates high school to pull the plug.
Xrayvsn, It is a terrifying moment to quit working at a job that pays so well. You will still not be sure you have enough when you finally make the move. Only after a few years will you fully know the answer to that question.
I have that being totally retired has given me time to explore creativity with art. I never would of thought I would like drawing and painting. I think the eye hand coordination required for surgery also applies to drawing. No money in it but a new pursuit. Congrats.
Hatton, I’m glad you found something to fill in for a career. I also got back into playing music. Couldn’t do it as much when I was working full time.
Cory,
Thank you for an excellent article. I am transitioning from 35 hours per week to 10 hours per week at the end of the month. It was 10 hours per week will be in an area of subspecialty interest of high need. I’ve been working in primary care for 40 years and I realize my skills are not as sharp although different from a surgical set of skills. There are too many things to keep up with and primary care. I have chosen to continue in addiction medicine of which there is a tremendous need and it’s highly gratifying. I enjoyed coaching patients and helping them turn their lives around. Hopefully the feelings of Burn out will subside. I although I will not have rental property income, Social Security plus investments will fill your financial criteria. I am looking forward to grandchildren, traveling woodworking, staying fit and relaxing.
Great post. Your points are important for anyone who has hit or is approaching financial independence. When there, it becomes an actual decision about what to do! Having purpose is key and the idea of scaling back over time and developing those other non-medical interests and relationships in advance to make it smooth is important well before “retirement or re-purposing age”. Thanks for sharing your perspective from the other side. It is very helpful for those of us following a few years behind.
Cory,
Your suggestions are spot on, and speak directly to many of my concerns as I approach the transition phase, particularly the need to retire to a purpose.
Thanks for the excellent article,
CD
I started Medical School at 35 and wanted to be sure to give back those years to medicine that a younger student would have practiced. I am now post-residency in Psychiatry 34 years without a break and fortunately (lucky I would say) to not have had a malpractice claim. So I have not been too badly burned by medicine. I work about 60 hours/week; part-time private practice (all Zoom now) and 4 days/week at a prison managing the admissions ward. The prison work requires a great deal of skill, so I find it rewarding, albeit demanding. I don’t need the money (I’m way past that $1,000,000 mark). I find it hard to turn down the money, I enjoy my work, and I tell family/friends “my vocation is my vacation.”
As you can imagine, I’m way off-kilter, it IS time for me to retire, but I can’t seem to take that step. The need to accomplish at the highest level is both a benefit and a curse.
I am now 77, married 55 years. Our partnership in marriage is not the same as it was when we were younger. We love and cherish and have always been true to each other, but for both of us spending 24/7 together has not been in the cards since we were married and would not go well now. We are not the same people we were when we married, as to be expected. We are both obsessive but to different things.
My health is reasonably good (HTN), but I sense the slowing of my bodily functions. I love to exercise, especially biking and the occasional sprint triathlon, and I am able to continue those endeavors (always finishing last).
I find the concept of retiring to be a difficult if not impossible decision to make. I read many of the articles in this feed and so many writers can’t seem to wait to leave medicine behind them. I don’t feel the same. I really love (well, perhaps better to say like) what I do, there is NOTHING in life I can do better skill-wise than practicing medicine, so stepping away would be a huge loss no matter what the future holds.
I’d LOVE to meet/join other physicians with the same “dilemma” I am having. My email is below.
Nathan, thanks for your comments. I also struggled with wanting to retire but still liking what I did as a surgeon. Thus the four extra years of practice after I could afford to quit. It is tough to give up medicine.
I am struggling with this decision. I’ve been in private practice for 27 years as an adult recon orthopedic surgeon. The burnout started early as my partner and I were covering multiple ER’s and operating almost every weekend while trying to grow the elective part of the practice. Fast forward to now…..I’m 61 tomorrow, and a little tired. I don’t cover call anymore. The wake up call came when I developed a cervical disc that was excruciatingly painful. Performing surgery was ok but afterwards it was hard to find a comfortable position. Luckily it resolved with epidurals but I started to feel my age. Revision joint surgery is long and physically demanding. Additionally, I started to lose the passion. There’s something to being the “go to person” for complex cases. Ego, personal satisfaction, etc…. But eventually you realize that there aren’t any more mountains to climb. We are financially sound from our real estate and retirement funds. The error could be overestimating what you need and working longer to reach a goal that you already met. Then you lose out on time to enjoy your life when there’s still gas in the tank. Looking forward to moving on but still have the fear of making that step.
David, that same fear is why it took me three years to retire after I decided I wanted to do it. It is hard to let go. We will all let go at some time. But finding that sweet spot is key. I wish you the best in finding your sweet spot.