by Delbert Chumley, MD
Bexar County Medical Society
President 2007
No matter how far along you are in your professional career, one thing is for certain; someday you’ll have to decide if the time has come for retirement.
Medicine is one of the most rewarding professions in the world, and one unique aspect about it is that with experience comes greater satisfaction as a practitioner. Although the time is different for each of us, some day you realize that you feel comfortable in reassuring your patient that you don’t think there’s anything seriously wrong with him.
You may give him advice on how to manage his problem or treat him empirically with a medication and schedule a follow-up visit to assess his response. But what you don’t find yourself doing is ordering tests to verify your clinical impression.
Furthermore, you can sense that feeling of confidence from your patient and his trust in your judgment along with an appreciation that you’re not subjecting him to the additional expense of lab studies or x-rays.
You could call this “managing care.” I appreciated that feeling somewhere in my second decade of practice. It made me feel like I’d finally made the transition from someone highly trained in the science of medicine to being a doctor. It rejuvenated my love for this job and made me feel like I could do it forever. I couldn’t ever imagine giving it up.
That was what made it such a shock when I heard that one of my colleagues and good friends was retiring at the young age of 53! Although this happened several years ago, I still can recall the feeling of confusion and disappointment I felt to think that our
community was losing such a gifted, experienced doctor.
I remember asking him about it and hearing his answer, “Things are not what they used to be and I’m not happy doing this anymore.” I respected his decision, although I didn’t particularly agree with it. Unfortunately, I’ve heard that same reason expressed many times as we continue to see early retirement with ongoing dilution of the most experienced physicians in our workforce.
Maybe the older guys are focusing more on what they see as a problem with younger physicians: quality of life first, job responsibilities second. But I believe it goes deeper than that. My friend was right: things are not like they were. We somehow have lost a lot of our profession’s principles and values with the transition of how health care is delivered in our country. Although we may have improved the medical liability crisis with passage
of tort reform and proposition 12, there’s still the problems of diminishing reimbursements, increasing paperwork, rising overhead, federal and state government regulations, the under- and un-insured, patient non-compliance and an aging population.
Physicians have been forced to see more patients, spending less time with each in order to make overhead, and have permitted physician extenders to take over what was once their domain. If you lose that personal touch with your patient, it’s easy to understand how you can experience burnout in today’s rapid paced, demanding practice environment. However, I think there’s another reason which may not be as obvious, but in my opinion, may even be more important: the lack of professional congeniality.
Maybe you can blame it on managed care or the fact that more physicians are office based with the advent of the hospitalist, but the truth is, we are slowly losing contact with each other. When was the last time you actually sat down with a colleague and had a friendly conversation? When was the last time a new doctor came by your office to introduce him or herself? Do we even have hospital medical staff meetings any more, and if we do, does anybody attend?
Unless we keep avenues of communication open where we can discuss and solve common issues, our jobs will become overbearing and early retirement may seem like the only way out.
Your county medical society offers many benefits, including the opportunity to meet in a congenial environment. Take advantage of it and rekindle old friendships or make new ones.
After all, we physicians share common bonds that could be the ‘adhesive’ that holds the future of medicine intact and keeps experienced physicians at the helm of our profession. See you at the next BCMS function, I hope.
