As retirement approaches, find your ‘next big thing’
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“If you are going to achieve excellence in big things, you develop the habit in little matters. Excellence is not an exception, it is a prevailing attitude.”
– Colin Powell
“You are what you think. So just think big, believe big, act big, work big, give big, forgive big, laugh big, love big and live big.”
– Andrew Carnegie
The big stepping-stones in life are obvious when you are a young eye surgeon-to-be. Survive an uncomfortable adolescence. Get into the right college and enjoy the pleasures of undergraduate life with enough restraint to make it to medical school. Choose a specialty. More years of diligent restraint until you pop out the far end of the educational gauntlet.
Then, for the average ophthalmologist — perhaps the average human — the stepping-stones are less obvious, more random and more dependent on the hands of fate. Your first job. Partnership or tenure. Rising financial security. (Punctuated along the way by family life, hobbies and a few memorable vacations.)
And then, at about age 60 or so, come what might be called the “Chasm Years,” that often-unstructured decade or so sandwiched between attaining most of your lifelong professional goals and retirement.
We are getting a lot of calls these days from doctors at the start of their Chasm Years. Here is a typical composite sketch:
- Nearly 30 years in private practice.
- Nearly financially independent.
- A little bored and itchy with the daily grind.
- Still loving surgery. Clinic, not so much. Business irritations, even less.
- Unclear about retirement timing.
- Looking around for what may be their last professional hurrah.
- Excited about the prospect of launching their “next big thing,” but worried about whether they have the time, energy or risk tolerance to do so.
Client histories inform us that it is easy to fall into the chasm and hard to climb out. Only a minority of eye surgeons, it seems, actually launch any kind of “next big thing” before the years pass and retirement takes over.
To some of you reading this, that may actually sound attractive, like a runner jogging and cooling down on the last lap rather than sprinting to the finish. But for those of you seeking a race to the finish, here are some thoughts.
1. There are a finite number of potential “next big things” in a practice context; broadly, they break down into these domains:
- Practice growth: This can take many forms. You could simply keep building the practice you have: more visits, more cases, more office locations, larger territory and more providers. Or you could really go for it and spend the next 10 years quadrupling in size and market influence.
- Practice service diversification: Adding dispensing and primary care. Providing medical retinal services in an anterior segment practice. Or bringing in a guest oculoplastics specialist. Your “next big thing” may have nothing to do with financial diversification; some of the happiest docs I know have spent their last few years focused on charity care, whether in the local neighborhood or on the far side of the planet.
- Practice succession: Many practice-founding surgeons in their last decade focus their efforts on a continuance of their life’s work. By retirement, they want a safe landing for their patients and staff and the pride of knowing their work is being carried on. The best approach in some settings is to merge with a larger, multigenerational practice. In other settings, it can be feasible to recruit one or more partner-track successors.
- Practice downsizing: For some surgeons, the next big thing in their professional life is to reverse course, get smaller and reset the balance between work and the rest of life. Downshifting can take many forms: passing patients on to partners and working part time, eliminating services you no longer enjoy or feel comfortable performing, or (if you are in solo practice) trading practice profits for free time. I once met a surgeon who decided a decade before he retired that he would rather earn under $100,000 and tend to his life as a senior athlete. Another ophthalmologist works in his northern practice just during the warm months and then flies south, leaving his patients to an associate for the winter.
2. If you get stuck coming up with your “next big thing,” remember what it was like to be a high schooler and then an undergraduate. Thousands of options were still open. If you were like most kids back then, you went through periods of time feeling stuck. At least then, you had 8 years to figure out what you wanted to be when you grew up. Now, perhaps in your 60s, the clock is ticking faster, but the same principles apply. Like the young student, you are more likely to find something you love by exposing yourself to new things that deserve consideration (just as you may have volunteered in a clinic or hospital before deciding to become a doctor).
- If you have a two-doctor practice and are thinking about business expansion, talk with colleagues who work in a four-doctor practice to see if growth is everything you are imagining.
- If you are thinking about adding elective cosmetic services, make the rounds of peers in noncompeting practices to learn the success and failure factors of this challenging segment.
- If you are kicking the tires on merging with a larger, regional practice or partnering with a private equity firm, seek out those who have gone before you to learn if the benefits and trade-offs are balanced.
- If you contemplate downsizing, or if your “next big thing” is an early retirement, schedule a block of at least several weeks and take a trial retirement. (Some clients come back from these trials keen to cut back; others find the time off boring and reembrace a full schedule.)
3. Robin Sharma, a Canadian writer best known for his book, The Monk Who Sold His Ferrari, said “Dream big. Start small. Act now.” This could be the instructions for becoming an ophthalmologist: “Dream of cataract surgery, but stay up tonight to nail tomorrow’s biochemistry midterm exam.” But it is also instructive decades later for attaining your next big thing. You do not need to plunge into your great last act. But you do need to get on with it; the clock ticks faster at this end of your career.
4. Make sure your contemplated “next big thing” is going to be mostly fun. Although what you hope to accomplish may be serious — writing a textbook, inventing a clinical instrument, teaching residents or learning a new surgical maneuver — you are not going to get far unless you enjoy the process as well as the end goal.
5. What is “big” is up to your personal judgement. One surgeon’s desire to improve their cataract outcomes is just as worthy as another surgeon’s dream of opening an eye hospital in Kenya, and perhaps more realistic. It is better for the first surgeon to truly excel than for the second surgeon’s project to never get past the planning stage. There are no big things that are too small.
6. Have the courage to fail. But make sure that any potential economic losses do not exceed your risk tolerance or the practical boundaries of your retirement kitty. Through the years, I have worked with a number of elderly surgeons whose retirement was postponed by a “next big thing” gone bad. Once you come up with a “next big thing” plan, run it by your financial advisers. Do not place a bet with money you cannot afford to lose and do not have enough time to re-earn.
- For more information:
- John B. Pinto is the author of several books on ophthalmic practice management, including John Pinto’s Little Green Book of Ophthalmology: Strategies, Tips, and Pearls to Help You Grow and Manage a Practice of Distinction, UP: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance, and Career Satisfaction (with Corinne Wohl), Simple: The Inner Game of Ophthalmic Practice Success, and Ophthalmic Leadership: A Practical Guide for Physicians, Administrators, and Teams. Available now for purchase at slackbooks.com. Receive 20% off with promo code PINTO20. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.
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