Balls and Walnuts
more than you ever wanted to know
Update
My last OR day is 7/30. My last day in this office is 8/15. My first day in Santa Rosa is 9/2.
I get annoyed when patients assume I’m retiring. Either (A) they think I’m old enough to retire, or (B) they think I’m rich enough to retire. Neither is true, although (B) would be nice. Sadly, I chose the wrong field for early retirement. I wish I had been one of those lucky sods who hit it big during the internet boom, one of the ones who got out at the right time. If I had, I wonder what I would be doing with my riches and leisure time right now? Because I’m a working boy, after all; no Long Island Ice Tea on the 40-foot sloop for me.
So: what early retirement really means is the freedom to do the work I love and not have to worry about making a living. I suppose I could write part time, maybe keep up some sort of boutique medical practice on the side. I like medicine, but the 9 to 5 (or more often, 8 to 5 or worse) five-day-a-week grind is tiring.
I’ve often thought it would be fun and challenging to establish a medical consultancy practice catering to folks who feel that everyone else has given up on them. I wouldn’t be able to fix most of these people, but I could promise them that I would research their situation and come up with a plan of action that would have the best chance of producing results. I would run a cash operation and bill by the hour like a lawyer.
Yeah, that’s the dream. It’s sort of the opposite end of the spectrum from my present reality. Fact is, from medical school onward, a large fraction of my time has been devoted to indigent care. While I don’t mind this, at some point I have to step back and take a look at what it’s costing my family.
Even in this idealized practice, I could, of course, donate a portion of my practice to charity cases. Ten percent is the figure most often quoted as the amount necessary to facilitate an untroubled night’s sleep. I’m doing a LOT more than that at present.
Meanwhile, I’m doing the 8 to 5, and that’s not going to change any time soon. I’m afraid 8/15 can’t come fast enough, though. (Sorry, patients!) The steady rain of guilt has turned into a torrent. The guilt has matured, in fact. Used to be, I felt guilty for leaving my patients. Now I’m burnt out, guilt-fatigued, unable to feel much genuine guilt when patients insist, “Noooooooo, you caaaaaan’t leeeeeave!” And that makes me feel guilty in a different way, since I don’t seem to be capable of acknowledging their feelings with any true empathy. My honest reaction is, “Yeah, yeah, life’s a bitch. Next!”
Isn’t that awful? And yesterday, the daughter of one of my patients brought in a “crazy quilt” she made to thank me for the care I’d given her mom. It took her six months to make this. Six months. She started it even before she heard I was leaving, and she didn’t stop it when she did find out.
Nope, no guilt. No no no.
D.
You could go into alternative medicine. I think that’s where the big bucks are. You just mix together some herbs and spices, which you can get at the grocery store or Wal-Mart pretty cheap, charge more than most brand-name prescription drugs, and keep selling them more and more because it’s a health system. You have to take it regularly to see any results. It’s not that it doesn’t work or anything. No, you just have to keep taking it. And pay cash, please.
Oh, calm down. Stressing out will only make your condition worse. Here, buy one of my pet rocks. Hold him in your hand when you feel stressed. Feel how smooth and polished he is? No, don’t rub on the eyes, I don’t know how good the glue is. There you go, gently, gently now. $50 please. Yes, $50. That’s no ordinary pet rock. He’s a medicinal pet rock. He was specifically smoothed and polished for maximum stress-relieving tactile stimulation. And the stones are hand-selected for color to ensure a visually soothing and mentally relaxing clarity and tone. Like a diamond. Carefully selected and worked over like a diamond. You know what, fifty bucks isn’t enough for this gem. $399. And, I’ll include this fine padded box you can tote him in. No extra charge for the box. But, I have a fine linen bag you can carry the box in. Keep your medicinal pet rock safe and happy. That’s an additional $49.99. It’s a real bargain. That’s a very fine linen. Oh, and I’ll throw in a week’s supply of this herbal concoction for an extra $99. Heck. I like you. You can have it all for just $499. That’s a great deal! Okay, thanks. See you next week! Oh, here’s a coupon for $2 off your next bottle of that herbal supplement.
You know how many of my friends would be rich if they had just listened to me? I’m giving you the ticket here.
But, I expect a percentage. After all, I gave you the idea. 😉
Have you ever cosidered “concierge medicine” http://www.physiciansnews.com/business/204.kalogredis.html ? My husband helped get this group off the ground http://www.modernmed.com/website/default.aspx but he is no longer associated with them.
correction or amplification
u can write full time
I like the consultation idea.
About the guilt trips from patients: at the end of the day, you gotta think about yourself.
When I look at the teacher who is in the room next to me who stays after school til 5 or so helping students every day, I think, “well, that’s nice, but she’s young, and maybe she doesn’t want to go home to those two kids and her husband.” As for me? At the end of the day, on Tuesdays and Thursdays, it’s “gym day…everybody out…move it, move it, move it!” I am no good to these students if I don’t take care of myself.
Dan: some of us DO want to sleep soundly at night, you know 😉
Lucie: hard for a specialist to set up a boutique practice. Internal medicine or family practice, that’s a different story.
Torrance: if I do anything full time, I’m gonna get bored with it. Writing full time? I’ll end up playing computer games half the day.
Sis: I know, I know. And that’s what I’m doing. But it doesn’t fix the guilties, does it?
Guilt is a bitch…there IS no cure for it.
The burnt-out guilt thing reminds me of that Cheers episode where Norm was so empathetic with this guy he was told he had to fire that they made him the official hatchet man because he was so good at it he actually cried when he told the people and they took it well. By the end he couldn’t even fake it anymore.
You should feel good that your patients are upset that you’re leaving – it means you have helped them and been a great doctor for them and that they have a real rapport and feeling of friendship with you. But they’ll be OK – and you are moving on to another phase of life and will be helping a whole new set of patients.
I like the idea of your boutique doctor business after your retirement. Some people really need a doctor who will try to help them when others have given up.