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  • Thoughts on Slowing Down

    To only slightly paraphrase Hamlet: “To retire or not to retire: THAT is the question.”

    For the majority of Americans, this is, in fact, not a question at all. You work 30 or 35 years, you have a 401(k), you can afford to quit working, and so you stop.

    As ophthalmologists, we know in our hearts that we have been granted a rare privilege: restoring and preserving sight. Our very identity as a physician, as a surgeon and as a friend to many patients whom we have known for decades, prevents us from simply closing the door and walking away. Our profession is not an all-or-nothing proposition. At some level, we all believe in the adage that if you love what you do, you will never work a day in your life.

    As we get older, however, it is legitimate to think about slowing down. A little less work, a little less stress, a little more time with family, friends and personal interests is a legitimate goal. We need to participate in a natural progression of scaling back while still providing meaningful health care and continuing with a sense of purpose and accomplishment. Although it may seem obvious, it is extremely difficult to take a first step and begin to plan emotionally, financially and intellectually for a new, but still significant and important role.

    The psychological barriers are formidable. We must get past the denial and acknowledge that we are getting older, that our skills may not be as sharp, that health issues arise and that we don’t want to change our identity as a healer. In addition, we are now faced with a world of social change including health care reform, a hostile legal environment, Dr. Google, increasing government demands, the end of solo practice and the rise of large groups and hospital-based employment. How do you transition to being an employee after 35 to 40 years of running your own office and being in charge of your decisions?

    On the other hand, we have some positive motivations for slowing down. After practicing for several generations, enough of the fulltime pace and stress. We have always said that we want more time for family, hobbies, travel and for approaching this new phase of our lives with a sense of adventure. Now is the time to find balance between using your skills, experience and the value that you bring to patient care with a need to acknowledge that you have made a huge difference in thousands of lives. But to everything there is a season, and it is now time to wind down – not stop – and enjoy the fruits of a lifetime of labor.

    The first step is to realize that the process of slowing down can take time as you liquidate your assets (office, equipment, etc.), sell your practice, deal with contractual obligations and prepare to step away from your current pace. Your approach can include stopping operating (you can still do minor office procedures), stop taking insurance (this would mean fewer patients, but it would have less impact on your income). You may want to see fewer patients a day, take off a day or two a week. This way, every weekend becomes a three-day weekend. If you realize that you have an invaluable, experienced skill set, you may want to explore different work environments (i.e. working for a Veterans Affairs or other hospital or part time for other physicians), consult and even teach.

    Finally, and this is no small part of the resistance to slowing down, think about what you will do with your free time. The essential point here is that we are not quitting cold turkey, closing the office and walking away. LESS patient care is not the same as NO patient care. However, a little more tennis, a little more golf, a little more bridge, a little more reading, a lot more family and travel, a few courses, new and old friends, long-delayed hobbies and interests and whatever else you can think of represent not just a challenge, but a new and exciting world.

    After almost 40 years of working nonstop at a formidable pace, accepting staggering responsibility and functioning with a considerable level of stress, you have earned the right to slow down, not stop, and be kind to yourself.

    Good luck. Let the journey continue!