Looking to retire? Get ready emotionally

Medical Post
Helping Hand Column, February 27, 2007

“OK, it’s now the new year. Let’s get on with it,” my patient said grudgingly, as if we were about to start a root canal procedure. I realized he was speaking about the discussion of his retirement, a topic he had been deferring for several months. He just could not bring himself to consider retiring from medicine after being a doctor for more than four decades.

This was a far cry from the myth of “Freedom 55.” What a great sell that was—the ideal of the perfect retirement. The ads showed pictures of sandy beaches and palm trees, lounge chairs, hot tubs and hammocks; older couples youthfully laughing and playing. It depicted work as not fun and retirement as fun. There was a clear goal: to get from full-time work to full-time leisure as early as possible.

Yet, this has changed with a changing world. People are living longer, are healthier when older, and need to finance more years of life. People are better educated and want to continue to do something as they get older. As it is with medicine, people often get their sense of power from their workplace and want to maintain this. Our work defines us and we want to maintain this sense of self.

Mandatory retirement is mostly gone. Forcing employees to retire has become a human rights issue. Manitoba, Quebec, Alberta, P.E.I. and Ontario all have legislation to protect employees from age discrimination after age 65 years.

Our changing world requires a change in attitude. “Old” used to be a negative concept, associated with a sense of being less productive and less efficient. In reality, as a person ages, many of his or her abilities are unchanged. If one’s capacity decreases, it is compensated by increased experience.

A 2005 HSBC Bank survey showed that only 22% of Canadians see retirement as pure rest and relaxation. Most of us see it as a time for reinvention, pursuing lost ambitions or taking on new personal challenges.

The Harris County Medical Society Study showed that most physicians are pleased with retirement, with 33% stating these are the “happiest years.” Understandably, the first year of retirement is felt to be the most stressful. Most are financially comfortable, but the healthiest ones are those who are emotionally prepared.

The best way to prepare for a healthy retirement is to start early—at least by the age of 45. We will need to replace 40 to 60 (or more!) hours of work with other meaningful activities. It is hard to find new interests overnight. We need to identify these early and start to practise, to see if we will enjoy them. This process of transition takes about two years, and involves anticipating and accommodating physical and emotional changes, and grieving the inherent losses.

There are emotional challenges. The end of a long and successful medical career leads to multiple changes. There can be a loss of self-worth, of our own identity as a physician. Now who are we? What is our role in society? Suddenly, there is no place to go, no familiar structure and routine to our days, and a sense of isolation as much of our social life was centred on our work.

There are professional challenges. It can be difficult to slow down with a lack of support for coverage or availability of locums. Some medical groups require colleagues to take full call, even if they are cutting back hours at work. Professional organizations still require payment of full fees, regardless of how much a person works. As you work less, you can feel excluded and alone, and miss colleagues and the networking within medicine.

There are financial challenges. You need to feel you have enough money to do all the things you want to do, now that you have more time to do them. Regular consultations with financial advisers will help in the planning and creation of the savings required. Again, start early to plan for this, and set realistic and flexible goals.

Often our later working years become a blend of retirement and work. This can include working part time; mentoring junior colleagues and sharing skills and knowledge; remodelling job skills into volunteer work; or self-employment. In medicine, there are many options. You can:

• offer to do locums for younger colleagues on sabbaticals, maternity leaves, study leaves and holidays;

• do locums in underserviced areas such as the Canadian North;

• sign up for short-term missions or disaster relief programs;

• teach in a developing nation;

• modify your regular work, such as run a specialized clinic or assist a colleague;

• serve on review committees and boards;

• edit, review and write. We can teach; or

• focus on research you did not make time to do earlier in your career.

Ken Spencer, ex-CEO of Creo Products, summed it up well when he said, “Retirement is not about doing nothing. It is about doing what you want to do with the people you want to do it with.”

Key steps in planning for retirement:

1. Start planning early. It is never too early to think about it.

2. Talk to other retirees about what worked and what didn’t.

3. Talk to those you live with. It is “our” not “my” retirement.

4. Invest in your relationship now, because you will be spending more time together. Appreciate, praise, apologize if needed.

5. Determine how connected you want to be to your old work place. This will help in deciding what you will want to do and where.

6. Identify interests and start to practise what you think you want to do once you retire. Finding meaningful activities may take a year or more.

7. Stop before you start. Even if you want to do something else, first take a few months and do nothing. Do nothing until you can’t stand it anymore. You will then likely want to be busy again.

8. Do the things you want to do in life while you still can. Don’t put it off until later.

9. Help patients plan for transition. Discourage dependency, notify them about two to three months in advance, transfer charts.

10. Consider your colleagues. Express appreciation, plan to stay connected.

Mamta Gautam is an Ottawa psychiatrist who specializes in treating physician patients. If you have a question you would like addressed in this column, please contact Dr. Gautam at mgautam@rogers.com. Please include “Helping Hand” in the subject line. All inquiries will be confidential. Your questions will not be replied to, but may be selected to be answered in this column, which is intended to be educational, not therapeutic.