Mindfully Retiring from Psychiatry

I’ve been off service for months and I’ll return to staff the general hospital psychiatry consultation service on Monday. It can be a stressful role and I’m “mindful” of how helpful mindfulness meditation has been. The featured image above shows my yoga mat and some might say a much too comfortable chair for sitting meditation. And of course, mindfulness is not really about relaxation; that’s just an old pillow.

 About 5 years ago the editors of the Arnold P. Gold Foundation Humanism in Medicine Blog saw one of my blog posts (from a previous blog) describing my path to mindfulness practice, which included burnout, a problem for nearly half of all physicians, the causes of which include the health care system itself as well as physician vulnerabilities. It was posted under the title “How I left the walking dead for the walking dead meditation.” I was also the recipient of what was called in 2007 the Leonard Tow Humanism in Medicine Award, sponsored by the Gold Foundation.

Leonard Tow Humanism in Medicine pin
Getting the Humanism in Medicine Pin

This has me thinking about my motivations for retiring and what I’m going to do after I’m fully retired. Interestingly, the phased retirement program I’ve been in has given me a strong sense of how difficult this transition from full-time doctor to retired doctor entails. The meaning and purpose gap require more than a bridge made of recreational pastimes. The breath of relief after the great escape from work can soon become the sigh of boredom. On the other hand, my work as a psychiatric consultant has also been an enormous source of personal satisfaction. The video below gives a sort of Pecha Kucha account of what a Consultation-Liaison Psychiatrist does.

What C-L Psychiatry is about

It can get pretty hectic. Over the last two years of the phased retirement schedule, I’ve struggled to craft a daily routine at home that replaces the sense of accomplishment my work schedule provided—despite the pressures it exerted on my sense of well-being. Only now, in my third and final year am I starting to wonder the opposite.

For example, I’ve been exercising daily as well as practicing my mindfulness meditation. I’ve actually lost a little weight and my wife has noticed my shrinking paunch. I’m not laboring on my workouts by any means; my quads are not flopping over my knees. But I used to think that by climbing all those stairs and running all over the hospital I was staying in pretty good shape. It looked pretty impressive that my smartphone step counter logged around 20 floors and 2-3 miles a day. However, the consult service work demand can run hot and cold. It just doesn’t beat daily exercise.

How do I keep my daily exercise routine? I can hear myself saying that I won’t have time for it. I think my mindfulness teacher would probably remind me that my response could be to make time for it—just as I learned how to make time for mindfulness.

I’m looking for guidance in the literature on retiring psychiatrists, especially C-L specialists, and it’s pretty scant. So far, the best summary of it I’ve found were a couple of blog posts by H. Steven Moffic, MD on the Psychiatric Times web site. You can easily view them for free. In the first one, “Mental Bootcamp: Today is the First Day of Your Retirement,” published in 2012, he highlights the difficulty of psychological adjustment to retirement for psychiatrists. He advises, “Plan how to replace financial, personal, social, and generative needs that work has fulfilled.” There is no doubt I could do a better planning job.

In the second one, “Reviewing Retirement,” which was posted in 2014 (two years after he retired), he advises “Retire, even if you are not retired. Take enough time off periodically, and completely, with no connections to work, so that you can feel emotionally free from concerns about patients and practice.”

That speaks to me. In fact, the title of my blog site, Go Retire Psychiatrist, actually echoes this suggestion, although I never made the title with that connection in mind. I wish it were that easy to follow. You would be very lucky in today’s work environment to pull that off, even in academia. Phased retirement programs are one approach to preparing for retirement and could be effective for preventing burnout.

Go retire, psychiatrist.

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