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PHYSICIAN
RETIREMENT

Retirement from Medicine in Stages:

Slow Descent From the “Mountain”

By Jaime Pankowsky, MD, FACS

While in training and when in private prac-
tice, one does not think of retirement at any
time. That thought and feeling enters in our
mind as our circumstances, and sometimes our
health, begins to change; but not for the better.
Alongside the care of patients, duties in the hos-
pitals where we practice and paying off rents
and/or mortgages, we are concerned to care for
our families and see that our children get the
education they can obtain and accomplish.
But sooner or later, events personal, profes-
sional, financial and social begin to exert their
influence and make retirement a more imme-
diate concern. The “when-and-how” is differ-
ent for each doctor depending on the
physician’s conditions in health, finances, fam-
ily and age. Early on, when one’s practice be-
comes stabilized and settled, we begin
investing in annuities, IRA’s and/or the stock
market, thinking in a very distant future for
retirement. Until then we continue humming
along. And then, the children are grown up
and educated, the house mortgage is paid up
and changes are occurring in one’s profession and unsightly for the staff. Finally, a spinal fu- and stimulating, but it required traveling and
or specialty that we did not expect and for sion made standing in the operating room for attending meetings in Austin. At one point
which we were not trained. And then health long hours more problematic. So, health is- they chose to not have me on the committee
changes occur and retirement is looking us di- sues and changes in the specialty demanded I and I left.
rectly on the face. stop doing surgery. Other than those prob- Also, I spent about 18 months evaluating
I practiced general surgery for over thirty lems (none of them potentially fatal), I was in medical claims for the Social Security Admin-
years in San Antonio and then changes began good health and condition. But just doing istration. I gave it up, because judges seldom
to creep on my complacency. First, general nothing was not in my nature. I took on other had any use for our medical evaluation and it
surgery began to be replaced by subspecialties, activities. appeared to me to be a waste of time. I also saw
like colon and rectal surgery, bariatric surgery, I volunteered as a member of the Commit- how the system was being gamed and cheated
breast preservation, etc. One is at that stage, tee on Continuous Medical Education of the by people with false diseases (myalgias) or in-
or at an age, when returning to a training pro- Texas Medical Association and for a couple of significant injuries. I resigned.
gram is not an option. Second, I developed years I used to go with the committee staff to I decided to travel with my wife and, after
cryptogenic tremor in my left hand and this evaluate the educational programs of hospitals learning to scuba dive, with a club of scuba
alone made operating less safe for the patient in different cities in the state. It was interesting divers. Trips as close as Cozumel and as far as

24 SAN ANTONIO MEDICINE • April 2021