Strategies for Coping, Retirement Planning Critical to the Aging Radiologist

While the practice of radiology presents physical, cognitive and personal challenges to every radiologist, age-related changes provide further domain-specific challenges.

By Felicia Dechter

Stephen Chan, M.D.

Dealing with those challenges and grappling with issues including when to retire were covered by presenters of Tuesday's session, "The Aging Radiologist: How to Cope, When to Quit," an interactive session sponsored by the RSNA Professionalism Committee.

Presenters spoke on issues such as identifying the physiological and psychological manifestation of aging specific to performance as a radiologist, understanding economic, health, emotional and professional factors that stimulate radiologists to either continue working or retire, and identifying strategies for instituting meaningful and satisfying activities after retirement from active radiology practice.

Presenter Stephen Chan, M.D., an associate professor of Clinical Radiology at Columbia University in New York City, asked attendees to think about the barriers that may arise as they age.

"What are the physiological and psychological challenges to a radiologist's performance that increasingly manifest themselves as a radiologist ages?" Dr. Chan asked.

They are: Visual (cataracts are the No. 1 problem for aging radiologists), hearing, strength/flexibility/endurance, burden of illness/risk of disability—over a lifetime, and not necessarily just among older radiologists, he said. The most common physical challenge for radiologists is visual. Cognitive challenge can be ameliorated by technical and work environment changes, he said.

Nevertheless, there is no mandatory retirement age for radiologists, Dr. Chan said.

"As long as a radiologist of sound mind and body retains the competence, desire and personal/professional integrity to practice radiology, there is no physical or mental basis for anyone to insist upon retirement," Dr. Chan said. "Of course, there may also be personal choices, economic reasons and other professional options that affect this decision."

In fact, many older radiologists are functioning just as well as their younger colleagues, Dr. Chan said.

"Older radiologists have the advantages of greater experience and wider breadth of knowledge in their field," Dr. Chan said. "Younger radiologists have the advantage of more recent exposure to prolonged periods of intensive study, especially to new developments in the field being promulgated by their professors and teachers."

Preparing for Retirement

Policies for addressing the potential for health or age-related impairments are rare, but there are a number of ways to plan for retirement, said Bruce Barron, M.D., a professor of radiology and chief of Nuclear Medicine at Emory Crawford Long Hospital in Atlanta.

Those include: Figuring out power of attorney; tilting of assets; wills; trusts; beneficiary designation; getting information on Medicare and seeking out alternative living options, among other things, said Dr. Barron. "Make sure you and your spouse are on the same page," said Dr. Barron, whose presentation focused on why people retire, how to deal with people that are aging, and preparing for retirement.

Of the 36,000 practicing radiologists, 7,000 radiologists age 56 to 65 are working fulltime, Dr. Barron said. "There is some notion of discrimination," said Dr. Barron. "I've seen it happen."

The average retirement age for a radiologist has dropped from 70 to 64, said Robert Schmidt, M.D., a retired professor of radiology at the University of Chicago. Dr. Schmidt spoke about retirement issues that may be unexpected such as savings and healthcare costs including Medicare and Social Security timing.

Many radiologists feel lost without their daily focus and routine, Dr. Schmidt said.

To that end, the importance of activities to keep radiologists busy and productive in retirement was the focus of a presentation by William Casarella, M.D., an Emeritus Professor at Emory University in Atlanta.

"A radiologist should only retire if there is something to retire to," Dr. Casarella said. "Pursuing a long standing interest or avocation is critical to a happy retirement."

Dr. Casarella said his "major message" to radiologists is to invest some time in developing an exciting post-retirement activity during their career. "The scope of activities is, wood working, tutoring children, medical work abroad, writing, are just a few," he said.

There is no doubt maintaining excellent vision is a problem after 65, Dr. Casarella said. "However, the abilities of some radiologists are well-maintained until later 70s and 80s," he said.

Nevertheless, there will come a time when reality sets in, Dr. Schmidt said. Stamina wanes, it's hard to stand all day doing biopsies, hands shake a bit, concentration can wander, he said.

"I did a lot of breast biopsies in my time, but in later years I developed a mild tremor, which I could overcome, but it made it just a stitch harder when targets were very small, which was my special talent before," Dr. Schmidt said. "The AMA in 1999 gave a number for MDs over 90 still working: 1,200 in the U.S. And your feeling about a sound mind might not correspond with what your colleagues objectively think.

"Some doctors need to be apprised that they're no longer meeting the mark—difficult, but real," Dr. Schmidt continued. "Many may keep working as they need the money, or would feel diminished if they gave up the status of their positions. I feel gratified when one of my fellows goes on to best me at something."

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