Oncology is a demanding field that requires special qualities to care for very sick patients, many of whom will die prematurely of their disease. Research indicates that years of facing life-and-death decisions in the clinic can be associated with oncology burnout syndrome, which effects physician quality of life in a number of ways.
Over the past 2 decades, there has been increasing focus on the causes and consequences of oncology burnout; however, there has been relatively little in the literature about how oncologists adjust from a busy practice into retirement. To gain insight into this inevitable but tricky transition, The ASCO Post recently spoke with Mark J. Clemons, FRCP, Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada, who has investigated and published on the topic.1
Starting the Discussion
Why did you and your colleagues begin examining oncology retirement?
In oncology, we have laser-like focus on delivering personalized medicine for our patients, and I think we sometimes forget the personalized aspects of ourselves as cancer providers. And thinking about aging and retirement is part of that process.
A lot of colleagues wondered why I was looking at this issue and asked me who I’d spoken to. It’s sort of a hush-hush subject, which is part of the problem. Although we may have informal “corridor discussions” about retirement, usually with older colleagues, there is little practical guidance for a successful transition into retirement.
As a very intense oncology career begins to wind down, there are stresses in planning for the future. We should all plan for a future beyond full-time oncology, so we thought we’d start the discussion.
Timing of Retirement
When do most oncologists retire?
That’s an important question to answer when planning retirement, because if you have an estimate of when most of your colleagues retire, it helps gauge the likely duration of your own career. That said, it’s difficult to gather up-to-date data on oncologists’ retirement ages. Interestingly, we found that in the United States and Canada, most oncologists are aiming to retire at about 64 or 65, but the majority transition into retirement in the few years after 65.
A quote I paraphrased during my research into oncology retirement was, “No one ever said on his deathbed, ‘I wish I’d spent more time at the office.’” The relevance of that quote is simple: If we knew when oncologists tend to die, maybe we could make better choices about when we choose to retire. Although we were unable to obtain data on the average age of death for oncologists, we know that the average age of doctors dying in the past 20 years is 77 years for all specialties; this average age is likely to increase in the future.
Planning Retirement
When should oncologists begin serious retirement planning?
It’s important to retire at a reasonable age with a solid plan that lets you maintain a good standard of living. This is especially important in the uncertain economic environment that we face. Over the past 5 years, most of us—even more so in the States—have seen our pension contributions reduced in value.
So it is vital to begin planning early, and the best way to do that is to find a financial advisor with whom you are comfortable, one who understands your particular needs. It’s an important step in developing a personalized and comprehensive financial plan. In order to maintain the lifestyle to which one has become accustomed, a common formula is that one should save enough to be able to draw 70% of preretirement annual earnings.
Naturally, salaried oncologists in academia have different sets of challenges from their counterparts in private practice. Again, a good financial advisor will be able to match investment and savings plans to your specific salary and lifestyle needs.
Sense of Loss
How do oncologists generally approach the actual process of retirement?
It varies. Some of our colleagues have retired “cold turkey,” and that approach worked for them. But we also found that certain oncologists who went the cold-turkey route got this sudden sense of emptiness in their lives.
Even though oncology is a physically and emotionally demanding profession, there’s a great deal of satisfaction and self-worth in caring for sick and vulnerable patients. So there can be sense of loss, which is associated with its own set of problems as you age. Whether to use a cold-turkey or stepwise process depends on the individual.
Are there ways to prevent post-retirement issues such as feeling a sense of loss?
We found that many oncologists try to fill their once incredibly busy lives with substitute activities. For instance, a lot of doctors said that they were going to travel more. However, that’s a bit of a clichéd answer, and if you’re not traveling before you retire, chances are that you’ll not travel after you retire—and if you do, there’s a good chance that traveling won’t fill the void you’re experiencing. But if you had a pre-retirement avocation such as music or painting, for instance, retirement can be a good time to expand your talents. In other words, do something that’s rewarding, not something to fill the time.
Moreover, if you love medicine, you can participate in research committee work or any number of volunteer projects that require medical expertise, such as mentoring younger colleagues. Some retired oncologists find great reward in working in underserved areas, developing nutrition or pain management programs. There are also numerous study activities—such as learning about a new tumor type—that can keep you intellectually engaged in your retirement. Again, this is all part of the planning that makes for a successful and rewarding retirement.
Closing Thoughts
Do you have any last thoughts on retirement after a career in oncology?
It is important not to get lost in the transition. Retirement planning is vital for oncologists to enjoy the remaining years of life. Surveys have shown that the first year is often the most stressful. Up to 27% of retired physicians exhibit some signs of depression.
This is an incredibly complicated process, and we have no formal teaching or structure to help the retirement transition. By 2020, 50% of the oncology workforce in the United States and Canada will be aged 65 years or older. So on a practical level, proper planning will help our younger colleagues plan for better resource allocation as we retire. Planning ahead has benefits for the individual oncologist’s quality of life, as well as for the system overall. ■
Disclosure: Dr. Clemons reported no potential conflicts of interest.
Reference
1. Clemons MJ, Vandermeer LA, Gunstone I, et al: Lost in transition? Thoughts on retirement—“Will you still need me, will you still feed me, when I’m sixty-four?” Oncologist 18:1235-1238, 2013.
How Are You Planning for Retirement?
Share your thoughts and expectations on retiring from a busy oncology career. Or if you already are retired, let us know how you are enjoying this next phase. Write to editor@ASCOPost.com.
