Are physicians dying to reach retirement?

One of my clients is an avid farmer. For years, all he's talked about is farming. Farming this, farming that, farming, farming, farming. You get the point. He's also a doctor with less than five years until retirement.

For years we've been planning his retired "life on the farm" and moving steadily in that direction. First we figured out what kind of farming, then how much land would be needed. We talked about what the farm would cost, where it would be located, and we even discussed the pH of the soil. Then one day this physician who I'll call "Dr. Farmer" finally bought the farm (figuratively speaking). Today he's plugging away tending his crop when he's not working in the OR.

But there's one problem.

In order to live on the farm, he must file a permit to build his dream home on the land. So far though, he's procrastinated in every imaginable way and just not finished up the paperwork. I've done my part by pushing, pulling, encouraging and even threatening (politely) to little avail.

And then one day, I had a thought... maybe Dr. Farmer does WANT to retire.

Sometimes hen I talk with doctors about their retirement plans, I feel like I'm having a conversation with someone who is dying. After all, the very best physicians are totally dedicated to what they do and since you were old enough to want to become a doctor, you've seldom considered doing or being anything else. You love what you do, and you'd be glad to keep on doing it until you died (if the folks at CMS and the malpractice bar would just leave you alone).

In fact, the physician retirement phenomenon reminds me of the five stages of grief and loss developed by Elisabeth Kübler-Ross, MD in her 1969 book, On Death and Dying.

Here's what I see:

  1. Denial: When I'm fortunate enough to begin working with the young version of Dr. Farmer (you know, the doctors who hasn't made any mistakes yet), and we start talking about retirement, I always (and I mean always) hear him say something like, "Retirement? I love medicine, and I never want to retire."
  2. Anger: Later, Dr. Farmer realizes that the practice of medicine is not what he had imagined; that the locus of control is seldom within his grasp, and it pisses him off to think that - in the healthcare system - he may be the nail instead of the hammer.
  3. Bargaining: As Dr. Farmer begins to see retirement as the only* way he's going to "get his old life back" he begins to contrive machinations around having his cake and eating it, too. I often hear mid-career physicians say that they would like to retire, but they still want to work part time. It's a compromise to the all-or-none version of retirement you see on the Fidelity commercials.
  4. Depression: Then one day Dr. Farmer realizes life will never be the same again. Once he's hung up his practice, he'll still be "Dr. Farmer" but he'll never again be "Harold T. Farmer, MD". A funk ensues, along with some irrational behavior that seems perfectly logical given the circumstances.
  5. Acceptance: If Dr. Farmer is lucky, he'll come to accept the thought of his retirement sooner, rather than later, and get with the program by doing eyes-wide-open retirement planning while stashing some serious cash. If Dr. Farmer is late to the acceptance concept, he'll plug away in the clinic when he's way past the prime of life because he failed to do the things he should have done to make retirement a pleasant experience.

Even though I've been a financial advisor for thirteen years how, I'm still learning, and the thing I've learned about retirement is that you can't hurry the physician or his/her family. All I can truly do is plant seeds, water regularly, and wait for the idea I've planted to take root and grow.