Where to start when considering retirement from private practice
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In this issue, Jonathan D. Leffert, MD, talks with Raymond Fink, MD, about preparing for retirement. Fink retired in the spring from the San Diego-area private endocrinology practice he co-owned since 1986. He now has more time for reading, studying and teaching at his local synagogue and for longer family trips with his wife, Rhona, a recently retired primary care physician.
“My wife says we are in a sort of golden spot now when we have health and time and some resources,” Fink said. “You don’t know how long that window lasts.”
Leffert: When did you first contemplate retirement, and what steps did you take to begin the process?
Fink: About 4 years ago, my practice partner and I were having coffee and started talking about the future. He said he thought he’d work for another 4 or 5 years, and I said that sounded about right. That was my first articulation of the word “retirement.”
Then COVID hit and accelerated my timeline. My partner and I were not part of a group, and we had to transition our practice to remote health care. Like many, we muddled our way through and had to make some strategic changes. We closed a satellite office and a clinical lab. We began to think about how we would continue under COVID conditions long term. Our hard deadline, though, was July 2022 when our office lease was expiring. I did not want to be committed for another 2 or 3 years. I was ready.
Leffert: What resources did you use to plan your exit?
Fink: If you work for a larger health care system, retirement can be fairly straightforward. Most of the details are taken care of for you. Someone in my situation, however, has to do this on their own.
I found that most of the resources out there didn’t really pertain to someone in private practice — they were too generic. I did reach out to one colleague with a specific question about selling a practice. To others, I’d recommend contacting endocrinologists who have recently retired from a similar practice situation for specific advice or experience.
Leffert: Did you sell your practice? What did you consider?
Fink: Selling a private practice can often be more of a liability than an asset. That may seem counterintuitive, but I realized fairly early on that I did not want an extensive process involving attorneys and accountants. I knew that I wanted to leave and hand over my practice to a good custodian and steward who would take care of my patients.
That was not easy. One difficulty we in private practice face when we retire is finding someone who is interested in doing what we have done for many years. Many younger physicians prefer a job with a salary structure and do not want to be as involved with all the details of running an independent business. They prefer not to take on the risks of private practice with all the unknowns.
I did eventually find someone who had recently started in practice here in San Diego and was just beginning their career. Many of my nonmedical friends were astounded that I didn’t sell the practice, but just turned it over. For me, though, that was a cleaner break. I found someone I trusted would be a good steward and take care of my patients, and in return, I was relieved of the headaches of closing down a practice and taking custody of paper charts for years to come. It was simpler and worth it to me from a peace-of-mind perspective.
As the months have gone by, I feel even better about that decision. I want the new doctor to be successful, but I don’t feel the obligation to go and help out. I never had electronic medical records. When I decided to retire, I would walk around my office looking at all these paper charts. Patients were going to ask for their medical records, and I had 30 years of charts to deal with, let alone trying to find new doctors for them. To be able to just hand over the charts was a huge relief for me — well worth any money that I could have made with a sale. In addition, I had two employees, and the doctor who took over the practice was willing to take them on as well.
Leffert: Any pearls of wisdom for other physicians thinking about retiring?
Fink: Pearl No. 1 is that you have to see yourself as more than a physician. I have found speaking to some colleagues that many physicians are almost frightened about the idea of retirement because their persona is being a physician — they can’t imagine themselves as anything else. My wife points out that only men think that way: Women don’t have any problems seeing themselves beyond being a physician, she says, but many men do. If I had it to do it over, I wouldn’t choose any other career besides endocrinology, but I recognized that it was time to move on.
Pearl No. 2 is that you have to articulate your desire to retire to yourself and to others. It has to feel really right before you pull the trigger. Say out loud to colleagues and friends, “I’m thinking of retiring.” How does that make you feel? How are you handling the questions that come back? Are you feeling confident with the answers, or are they making you think?
The third thing is that you have to have a realistic financial idea of what’s going to transpire. A number of years ago, our financial adviser asked whether we’d thought about retirement. He sent a worksheet about expenses and such, and I spent about 5 minutes filling in numbers before returning it to him. Then I emailed him later that day and told him to disregard everything because those were probably made-up numbers. I wasn’t taking it seriously. Then Rhona and I talked realistically about what we were going to spend money on, what our primary expenses would be. Our financial planner ran through some realistic, conservative numbers and told us we could do this.
Leffert: Was there anything that surprised you about the process?
Fink: One thing I didn’t expect: I sent out letters to my patients about 6 months before I retired, when we had the new doctor in place, and subsequently, patients would come in for a last visit. I wasn’t expecting how emotional some of the patients were. In fact, some of the ones that I least expected talked about how they had been my patients for 25 or 30 years and how grateful they were, and they sent little notes or small gifts. I frankly was unprepared for that. I wasn’t expecting that as a specialist. That was very gratifying.
Jonathan D. Leffert, MD, is managing partner at North Texas Endocrine Center and past president of the American Association of Clinical Endocrinology. He is an Endocrine Today Editorial Board Member and the Putting It Into Practice column editor. He can be reached at jleffert@leffertmail.com; Twitter: @JonathanLeffert.
Raymond Fink, MD, is an endocrinologist and former practice owner in San Diego. He can be reached at rrayfink@gmail.com.
Share you questions about and experiences with retirement in the comments section or email the editor at endocrinology@healio.com.
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