A Personal Perspective on the ‘Big R’- Retirement

As the Department of Medicine prepares to launch our retirement toolkit to support late-career physicians, we are gathering stories and perspectives from faculty members who have retired from the Department of Medicine. Offering a personal perspective on the 'Big R' is Professor Emerita Anne Kenshole.

Dr. Anne Kenshole is a Professor Emerita of Medicine and Obstetrics and Gynecology. Prior to her retirement in 2013, Dr. Kenshole established and was medical director for the Tri-Hospital Diabetes Education Centre (TRIDEC), the first diabetes education centre in Toronto, at Women’s College Hospital. She was also a founding member of the Society of Obstetrical Medicine and a member of the Banting and Best Diabetes Centre. Her clinical research interests focused on diabetes management, particularly during pregnancy. Dr. Kenshole now continues to engage in medical activities that include medical-legal work, providing clinical care to unique patient groups in family physician office settings, volunteering with medical care to Syrian refugees, and is an assessor for MAiD.

A Personal Perspective on the ‘Big R’- Retirement

The following Do’s and Don’ts are drawn from personal and colleagues’ experiences.

Step 1

Do’s

Timeline: Two years before the ‘Big R’ day’

• Spousal agreement and support are crucial for a successful transition
• Plan early and be flexible
• Consider the big picture:
  • a) quit practice entirely
  • b) modify your practice
  • c) a change of direction - such as continuing to mentor and/or teach, expand your medico-legal expertise, do insurance assessments, use your skills and experience in the developing world etc.
• Think creatively and be prepared to change your plans (several times).
• If your choice is to continue in modified clinical practice, consider such options such as working part-time with a family practice group at a convenient location, together with the possibility of consulting for other GPs nearby.
• Decide how many days you want to spend in office practice. You can be as busy as you choose with the opportunity to increase or decrease your clinical work over time – it’s your choice. Continuing on a part-time basis has several advantages, including being able to remain involved in the care of patients with whom you have a special relationship, maybe going back decades.
• Visit a few practices that you are interested in, ideally with different “flavours”; meet with your potential colleagues as well as the support staff.

Step 2

(‘Big R’ day) minus one year

• If you have hospital privileges and/or an academic role, inform your department head, division director and administration.
• Arrange to visit two or three pre-selected practices that are of potential interest, consider their location, proximity to labs etc. the number of practitioners, adequacy of administrative staff and “sense the overall atmosphere.” This is invaluable in determining your ultimate choice.
• Explore the opportunities for linking with other referral sources if you want to fill your timetable. You can decide whether you will limit this to offering “Consultation only” or with ongoing care.

Step 3

(‘Big R’ day’) minus 6 months

• Finalize the arrangements, including financial (commonly a 70/30 split) and maintain ongoing liaison with your chosen future practice.
• Obtain, if you don’t already have one, a list of names and addresses of colleagues in your specialty.
• Send a precis of the chart with a consult letter to geographically-appropriate selected specialists on behalf of longstanding or complex patients at the time of their last visit. (Yes, it’s time-consuming but much appreciated by both patients and colleagues.)
• Consider offering ongoing care at your new location for “special” patients with whom you have been involved for years, maybe decades.
• Set a formal departure date with your department and hospital.
• Arrange for destruction of out-of-date patient records and storage of those requiring storage. (Check whether medical records will help with this.)
• Liaise with CMPA as your code and annual dues may change (to your benefit).
• Notify referring doctors of your retirement plans and indicate whether you will be willing to accept ongoing referrals from them.
• Notify other GP groups in the neighbourhood about your impending arrival.
• Finally, say farewell to your colleagues, nursing staff and others whom you have worked with for so long.

DON’T rush to relinquish your license to practice! It’s a slow and arduous process to get it back if you later change your mind.

My personal story since “retirement”

• Since retiring in 2013, I enjoyed working for the next six years as the endocrinologist in a downtown family practice after leaving the hospital where I had worked for four decades.
• I continue to consult part time at a diabetes education centre.
• My medico-legal consulting practice has actually expanded. I continue to be on the Medical Advisory Board for the Ministry of Transport.
• I have become an assessor for MAiD.
• I travel more often and for longer duration.
• “I have improved my cooking skills.” (This is not necessarily supported by evidence.)
• I have dealt with the death of my spouse of 52 years. Having continuing professional responsibilities during a difficult time has actually been very helpful.

In hindsight, what would I have done differently?

• Really, very little, perhaps because I approached retirement with OCD in high gear (but it worked!)
• My plans to volunteer in additional and imaginative ways were overly enthusiastic. My long-wished-for joining a book club was a semi-disaster: too often, I had not read the book in its entirety, my pathetic excuse being, “I’ve not had the time.”

Anne B. Kenshole

Emerita Professor of Medicine U of T - and contented retiree