by Anu Bajaj, MD
A few weeks ago, our incoming ASPS President, David Song, shared an article from NPR on his Facebook page. This article asked “When Should Surgeons Stop Operating?” The NPR article discusses the issue of competency tests for surgeons as they age. These types of programs are controversial because the unfortunate reality is that most of us don’t want to take a test to tell us when we can no longer do our jobs.
Typically, many of us who are in the early or mid-portions of our careers rarely think about retirement or what will happen when we can no longer operate – at least I don’t think about it beyond asking the questions, “how much money will I need to retire? Am I saving enough?” But I don’t think about how I will reinvent myself after I’m no longer able to or desire to start my day at 5 AM, operate 3 days a week, and have an unending “to do” list which only seems to get longer.
Retirement is a more pressing issue for my father. He is now seventy-five. Last year, he tried to have a heart-to-heart discussion with me about his plans for the future; I think that I tried to avoid the discussion. At this point in his career, I don’t believe that he wants to work as hard as he once did, nor does he want all of the stress that comes with work. Starting this January, he has limited his practice to first-assisting me on my free flaps (about once a week), and limiting the remainder of his practice to hand surgery and facial skin cancers a few days a month. With his free time, he travels to see the grandkids and volunteers at our temple.
If you are familiar with my previous blogs, you know that in addition to my parents and husband, I have also relied on my dogs for guidance. Guinness is my oldest lab and is now almost nine. He has run with me the most since he was a puppy – every morning, slow runs, fast runs, short runs, and ten milers. However, during the past year (maybe longer), his heart isn’t in it anymore – he stops more for drinks from the sprinklers, and he is easily distracted. During the spring, I took him on a run and after one mile he stopped, basically telling me that he was done. Now, Guinness walks in the mornings. And I run with the younger dogs who can’t wait to get out the door.
Guinness knew it was time for him to quit running. Now, he is excited about going for a walk every morning – a leisurely opportunity to absorb the smells of the neighborhood. So, when does a surgeon know that it is time? Most of us know that as we get older, we can’t do the same things that we did when we were younger. I think back to being a resident and know that I can’t function with such little sleep again.
A different approach may be to think of it as a reinvention instead of as total retirement. Each of us will have different phases in our practices, and at different times in our lives we may choose to transition to a different focus. For many plastic surgeons at this point in their careers, the reinvention is from a primarily reconstructive practice to a more aesthetic practice; or some may transition from a private practice to an academic practice or visa versa; while others may transition from a solo practice to a group practice.
Recently, I’ve had the opportunity to make several changes in my practice – new employees, new office, etc — so I’ve really tried to think where I would like to go in the future, professionally and personally. In many careers, individuals are encouraged to think in terms of a 5-year plan, 10-year plan, etc. I know that for me, I’ve rarely thought in these terms. Instead, I’ve gone from one phase to the next – college to medical school, medical school to residency, residency to fellowship, etc. Initially, when I moved to Oklahoma City, my primary focus had been to establish a practice and perform free flaps successfully in private practice. As I continue to perform my weekly DIEP flaps, occasionally, my father will tell me that he won’t be able to assist me forever. And, I have also realized that I may no longer want to do as many free flaps at the same rate that I currently do.
So, at this juncture, I have to develop a 5-year plan and a 10-year plan for the future and determine how I will reinvent myself. Regardless, of the path, it appears that our careers aren’t stationary, and neither is retirement. We will always reinvent ourselves to fit with the changing times or our changing bodies or our changing needs. As surgeons and professionals, we have to be aware when these changes occur and may mean that we need to accommodate our work – scaling back on surgery, performing less surgery, or not performing surgery — to these changes.