How physicians can successfully wind down their practice

A retirement plan isn’t usually a top priority for fresh doctors looking for their first jobs, whether that final date is in five years or thirty. Perhaps knowing when to hang up your hat is immaterial so early in your career since most doctors will end up leaving their first job within the first five years anyway.  However, I do wish that I had some inkling about the career paths at some point as during my medical school rotations.  Knowing how medicine is practiced and how practice patterns affect retirement would have probably influenced my career choices.

Interestingly, the specialty that you choose determines the means that you can even wind down.  This is because different specialties lend themselves to different work situations.

If you are a thoracic surgeon, you could work for yourself and contract with a local hospital.  If the hospital decides to employ its thoracic surgeons, you might have no choice but to join the party or pack for the hills. No matter how you intend to practice medicine, it is worthwhile to have some inkling how to wind down your job.

You might decide to hang up your hat completely and leave the medical world completely. Or you might want gradually wind down your hours.  Here is the list of options to wind down your practice:

Cut down your hours

If you are a shift worker, then you have it made.  Many hospitalists, nocturnists, and emergency room physicians can ramp down their schedules by taking fewer shifts.  If you belong to a large medical group, it isn’t that difficult finding someone who will be willing to take extra shifts for the money.  Pare down your shifts, and you can downshift your clinical practice as you wind down.

One of the emergency room doctors I know who is slowly transitioning to administration fills in roughly four shifts a month. I suspect that this number will eventually become zero as he renews his board certification through a non-clinical tract.

Sell your shares

Many partner physicians working in a large group can opt to sell their shares back to the company or to a junior associate ready to become a partner.  Depending on the practice, the physician can then continue working on a part-time basis as an employee as a means to transition the patients over to junior physicians.

Sell your practice

If you are the sole owner of your medical practice, you have several options to transition into retirement:

Sell to another fellow physician. Be awarded by allowing the tradition of medicine to continue.  You put in the hard work over the decades to build up a viable brand. Allow it to continue in the hands of another fellow doctor. Sell to a medical investment/management group. Perhaps you will receive a healthy buy-out.  Two million? Five million? Ironically, these groups may have very deep pockets so you may get more for your practice. Who knows what the long-term viability of this type of model will last, but it’s not like you’re going to care. That’s right, you’re going to be sipping a pina colada somewhere in the South Pacific. Sell your equipment, end your lease, and pack up. This might be one easy solution: Just quit.  Liquidate your equipment and office goods, fire your office staff, and call it a day.  The one downside of closing up is that you need to find a successor to continue care for your long-term patients.

Retire from your existing job and sign up for locum tenens work

If you end up selling your practice, you’ve basically closed the door on returning to work.  Fortunately, there are plenty of part-time opportunities floating around in the world.  New Zealand? Sure! There are plenty of hospital systems or groups that need temporary coverage — that’s where you come in. You might be able to see a new part of the country as well. The downside is that if you intend to get rich from temporary work, you might be out of luck.  Some temporary jobs aren’t really going to be wildly lucrative unless the hiring practice is going to be incredibly desperate with deep pockets.  You have realized what you’re getting out of working part-time and what the hiring practice intends to get out of it.

Your retirement may be decades away, but it’s worthwhile to at least have a few thoughts on how your medical practice might look like at the end of the rainbow.