No, It Is Not Unethical to Retire from Medicine Early

The world of medicine is gradually growing more complex. Every day, doctors are brought face to face with ethical dilemmas while dealing with internal forces (cultural norms and biases) as well as external forces (patients, families, payers, and administrators). Primum non nocere – “First, do no harm” is a part of the Hippocratic oath and describes your duty to care for patients. However, you must always do what you believe is best for you, even if what you feel is right is retiring from medicine early. So, when did early retirement from medicine become an ethical issue?

The word ‘ethical’ can be divided into two definitions. The first definition of ‘ethical’ pertains to dealing with the morals and principles of right and wrong. To say that it is unethical to leave your job is to say that it is morally wrong. Why? Some believe that doctors are morally obligated to stay at their jobs because of the time and money invested in their training. However, in the United States, doctors pay for their own education. So, are you morally obligated to work to take care of others just because you can? The second definition of the word ‘ethical’ relates to acting in accordance with the rules or standards of proper conduct, that is, the standards of your vocation. Are you morally obligated to work forever? While doctors are held by several ethical standards, including the Hippocratic Oath, nowhere does it say that you cannot retire. “My response to the ethics of my decision to retire early: If you pay for the privilege of a medical degree and work hard to pay off this debt, should it be your decision if you want to continue to practice? The government did pay my salary as a resident, which amounted to a little more than minimum wage for four years of 80-hour work weeks. Do I owe something because of this? As for leaving my patients, I actually do feel a little guilty about this one. I love my patients. I also struggle with no longer using my degree for clinical practice, something I worked so hard for. We are already feeling the strain of physician shortages and this another thing that gives me pause. In the end, the burden of practicing medicine in today’s environment no longer outweighed the positives for me,” wrote Valerie A. Jones, an obstetrician-gynecologist.

The Hippocratic Oath is one of the oldest professional oaths. Since the 1950s, it has been revised and tweaked in an effort to modernize its meaning so that it reflects the changes of doctors’ ethical behavior in the modern world. Today, the Hippocratic oath is a common issue among healthcare. Should it continue to remain the ethical standard of patient care for doctors today or is it an element that should be retired? Several doctors have different views on this matter. “When you are a young doctor, usually you laugh about taking an oath in the name of long forgotten Greek gods. As years go by and you face complicated ethical cases, the oath begins to make more and more sense. Sometimes it can be a burden, but staying true to your pledge makes you finally realize that the Hippocratic Oath is a true jewel of humanity, as true and modern now as when it was first written,” wrote a vascular surgeon. Still, there are those who offer a contradiction. “Ethics and morality are taught long before graduating from medical school. Any oath is symbolic, and agreeing to it does not change a person's underlying honesty or compassion. Technology has advanced far beyond our ethics, and an oath centuries old cannot encompass all of modern medical science or practice. An oath of some form will remain, but it is window dressing, much like our academic robes,” wrote an orthopedic surgeon.

Doctor retirement is your own decision. Whether you or a family member is dealing with an upsetting diagnosis or you are simply exhausted of your field, you should be encouraged to retire. However, what is considered early retirement? Retiring after a few days, a few months or a few years? Here are just a few of the scenarios associated with doctor retirement over the years.

• Retiring in your 30s: Some of the doctors who decide to retire during this age group are those who decide to stay at home and care for their families full-time, those who transition to pursue a non-clinical career, those who suddenly become wealthy, those who transition to a higher paying specialty for the purpose of retiring early and enjoying their earnings or those who have an interest in traveling and performing missionary work.
• Retiring in your 40s: Some of the doctors who decide to retire during this age group are those who experience a mid-life crisis, those who decide to become more family-oriented, those who choose to follow their true passion or those who choose to pursue a job with better income.
• Retiring in your 50s: Some of the doctors who decide to retire during this age group are those who may experience a physical disability, those who are fed up with their job, those who feel financially comfortable to leave their job or those who decide to pursue a side project as an investment opportunity.
• Retiring in your 60s: Some of the doctors who decide to retire during this age group are those who feel they have completed their life’s work with pride and contentment. For a large percentage of doctors, retiring after the age of 60 is validation of having fulfilled a successful career.

“What will replace that feeling of satisfaction when you're no longer working? Without a detailed plan, you can end up with a bad case of buyer's remorse in retirement. As I tell my clients, successful retirees are those who don't just retire from something, but to something,” said Joseph R. Hearn, writer and financial adviser.

Retiring early from medicine is a very tough decision, but it is also very personal and to be made as you see fit. You may be feeling exhausted and burned out, you may have been diagnosed with a medical condition that requires you to rest, you may want to change to another career or you may simply want to spend more quality time with your family. Whatever the reason, you can only truly succeed if you are able to ensure the safety and well-being of your patients. If you feel the loss of authority within your field, you place cost-effectiveness above healthcare or you feel the pressures of providing quality care, then you are no longer working hard for the good of your patients and you will become cynical in your efforts. If you suppress your own feelings and opinions in the clinical environment, then making such a sacrifice will not allow you to truly benefit your own and your patients’ well-being. You should be comfortable in your decision as it is not unethical to retire from medicine early. If you work hard to put yourself through medical school, earn a degree, and pay off your medical loans, shouldn’t it be your choice whether or not you decide to continue practicing medicine?

“Given that I recently celebrated my fiftieth birthday and am happily ensconced in a writing career, it is unlikely that I will return to clinical practice. Sometimes this realization saddens me, but I no longer feel that leaving was weak or selfish. Instead I believe that because I’ve survived in the trenches and now have a bit of perspective, I can help advocate for changes that will allow other physicians to practice medicine in a way that is life-giving to themselves and the patients they are privileged to serve — the way I had hoped to practice when I first donned my white coat,” wrote Diane W. Shannon, a freelance writer.