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Views And Reviews Acute Perspective

David Oliver: Keeping older doctors in the job

BMJ 2016; 355 doi: (Published 24 November 2016) Cite this as: BMJ 2016;355:i6260

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Keeping in the job

My advice to anyone uncertain about retirement is to negotiate a continuing attachment to your workplace BEFORE taking the final step. You can always cancel such an arrangement later, but you can’t do the reverse – once you’ve gone, the door slams shut and you have no bargaining power to get back in. Like Brexit, abrupt retirement is a one way ticket to a cliff edge, with only uncertainty beyond.

In favour of retiring early is that you will be remembered as someone at the top of their game. Leave it too late and you risk that embarrassing situation which afflicts some actors – long past their best but addicted to the limelight, they have to be virtually dragged from the stage. I retired at 61, well in advance of such a scenario, but it was a consideration which influenced my decision: I didn’t want to be someone of which it was said “I thought he’d never go”.

Of course that kind of negative perception of oneself may not be related to any personal failings, but to institutional factors. Older doctors though stalwarts of the service may be seen by management as resistive to change, whether or not this is so in reality. Far better from their point of view to employ someone younger, cheaper and more pliable.

I was lucky to hold the same consultant post for 25 years, finding great satisfaction in looking after the same community, accumulating in-depth knowledge of patients and their families. This can make all-or-nothing retirement a particular wrench. For all the criticisms of the NHS there is still an unbeatable teamwork spirit. Hospital for me was like home from home, and I recall vowing that the only way I’d ever leave the place was in a coffin.

A TV drama which struck a particular chord with me was R.F. Delderfield’s “To serve them all my days”, in which a schoolmaster enjoys a long and fulfilling career at the same school where he finally becomes headmaster. Then in the fullness of time, he ends his days watching the boys play cricket. For the vocational doctor who remains able and competent, why retire at all? One could do worse than pass peacefully away in one’s office at the end of a ward round.

Ultimately it is a very personal decision, and there are no right and wrong answers. The moment when there are clinical guidelines on retirement, that’s the time to retire.

Competing interests: No competing interests

01 December 2016
John R. King
Retired psychiatrist
Redditch, Worcestershire