Stay or go? Myriad issues shape retirement plans

Similarly, the national Lifestyles in Surgery Today (LIST) survey conducted by researchers at the University of California Davis Medical Center and the American College of Surgeons reported that surgeons contemplating retirement are strongly influenced by burnout, declining reimbursement, government interference, and shortages of medical students entering the specialty (see, "Survey: Surgeons bemoan reimbursement, work hours," http://www.urologytimes.com/surgeons/).

Urology Times asked urologists from around the U.S. about their retirement plans. While all said they had thought about retirement, a number of factors-in particular, the stock market crisis in the fourth quarter of 2008-are wielding considerable influence on how they currently perceive their retirement.

"I had hoped my son would join me in my practice. We never pushed him into medicine, but I was so pleased he went into urology. I thought he could take over my practice, but he decided San Francisco was not a great place for him," Dr. Brant said.

The 77-year-old urologist has looked elsewhere for a successor, but the shortage of urologists combined with rising reimbursement costs may make that difficult.

"I've interviewed a few fellows, and it's turning out that it might be easier for me just to retire and terminate the practice, rather than try to bring someone in," Dr. Brant said.

"San Francisco isn't the easiest place to practice because of the cost of living. A urologist can make the same money where the cost of living is much lower. Several people expressed an interest, but they want guarantees, and I can't guarantee what they're going to do.

"I'm still talking to one fellow. I would like to retire this year. I've already given up surgery, and if I wait much longer to retire, I won't be up enough on urology to keep doing it."

Almost 900 miles away in Vail, CO, Dr. Brant's son has a different perspective. Four years into a urology partnership, William O. Brant, MD, said, "My father's 42-year career as a solo practitioner in San Francisco is kind of an advertisement for this field of ours. I would have to say, though, I know very few people of my generation who really think they are going to practice that long.

"Much of what my dad enjoyed in his practice has changed over the years, and most of my contemporaries think of urology differently than he did. I think he considers us all a bit lazy because we do have other interests and we take more family time. That just wasn't something his generation did. They were really urologists first.