Retired surgeon shifts gears with career

As it turned out, I did not succeed as a retiree, so I have returned to work as a primary care physician (PCP). Doing so was not easy, however, and I would like to share my experience-not as words of advice but rather as a cause for reflection.

SURGICAL BEGINNINGS

After my residency, I took a job with two excellent surgeons in Pottstown, Pennsylvania, performing general surgery of the old-fashioned kind. We didn't have subspecialists in town, so, in addition to performing the usual general surgical procedures, we were involved in thoracic, vascular, and pediatric cases and, most remarkably, in the treatment of fractures.

This wide range of daily assignments was exciting, but I had no academic activity and no conferences to attend, except for the required monthly one about mortality. My only form of "education" was the frantic reading before performing an internal fixation of a fracture and other forms of on-the-job training.

After 2 years, I could not resist making a change-I accepted a job offer in Allentown, Pennsylvania, where I would be doing a more limited scope of general surgery and where I would be participating in a residency training program that had been around since 1934.

I joined a busy private practice group, and the change worked well for me. Medical school affiliations provided additional opportunities for teaching, which was refreshing, and involvement in the residency training program was a great source of satisfaction.

I enjoyed the combination of teaching, learning, training, and patient care for 33 more years, but at age 65, I found that my feet were hurting at the end of the day, and getting up at 3 a.m. was losing its charm.

I was still working a full schedule, but I noticed that it took me 5 minutes longer to perform a routine hernia repair. This change was noticed only by me and by my favorite scrub nurse, but it would only be a matter of time before others would take an interest in my performance.

It was time to let my partners know that I would retire the following year.

And, in June 2001, at age 66, I did retire. I converted my Pennsylvania license to the "retired active" category, where the biennial fee is the same, but there are no requirements for malpractice insurance or CME credits. I could prescribe medications for myself or for my wife, but no other practice of medicine was permitted.

To reactivate the license, I would be required to obtain 100 hours of CME credits, get some sort of malpractice insurance coverage, and pay $5.