Avoiding Retirement

Marc Lachance is the perfect consultant. Ten years my senior, he had more than mastered his specialty by the time I came to the area. He had also established himself as a mentor to Cityside Hospital’s residents and many young physicians who sent him referrals or called him for curbside consultations.

Marc used to live in a rambling farmhouse not far from where I live. But then his elderly father, widowed and suffering from macular degeneration, needed more help in order to stay in his own home. Marc moved to the opposite side of the city to be closer to his father. Marc’s wife was able to look after her father-in-law while Marc commuted to his office downtown. When his father passed away, Marc and Elaine stayed put, even though Marc’s commute was long.

Marc would follow some patients through the decades, but more often he would do a consultation and perhaps a follow-up. Then he would dictate a letter, right in front of the patient, to the referring physician with a detailed care plan. Marc welcomed follow-up calls from his colleagues and he insisted on getting continued updates on patients he had seen in consultation.

Unlike many specialists, he prided himself in his broad knowledge of medicine. I often ran into patients who had seen Marc for a consultation pertaining to his specialty, but had been diagnosed with cancer, hepatitis C and other conditions by Marc.

Whenever I called Marc for curbside advice, he told me exactly what I needed to know in order to move forward with my case. He never put me down if my call was disorganized and less than well prepared. But his own clarity of reasoning and exquisite mind for detail always made me feel I had been to school or a motivational seminar: “This is how a physician should be”, was the thought that lingered after getting off the phone with Marc.

Marc’s partner, whom I had fewer dealings with, retired a year ago. Many of us primary care physicians quietly wondered what was going to happen now.

Yesterday, a patient I shared with Marc brought in a letter she had just received. It was a printed letter that read:

“Dear Patient,

After more than 35 years, I will be closing my practice on December 30, 2013. For many years I have commuted a great distance to my office. As I am soon turning 70, and hoping to avoid retirement, I have made the decision to relocate my practice to Meadowview Hospital in Cornish, which is closer to my home. I will be an employee of Meadowview Hospital without the concerns of managing the business of a medical practice. By making this move, I am hoping to be able to practice medicine well into my eighties if I continue to enjoy the good health I have been blessed with.

I would be happy to continue seeing any patients who wish to transfer to my new location, but understand if most of you will want to find a specialist closer to where you are. Drs Jonathan Bard, Sheldon Mintz and Ravinder Pran all accept new patients in their Cityside Hospital Clinic.

I appreciate the confidence you have placed in me and wish you the best future health. Your primary care doctor has always received copies of my notes and your complete medical records are available for transfer by contacting my office at the above telephone number….”

I slowly handed the letter back to my patient.

Marc, I thought, you are teaching me something every time: How to be an up and coming young doctor, how to conduct yourself when you are in the prime of your career, and how to stay in the most fascinating job in the world as long as you possibly can. I know you love medicine, possibly even more than I do. I also know that you are at least ten years wiser than I am about being a human being, a son, husband and citizen of the world.

Bonne chance, mon ami, and may you never retire.

2 Responses to “Avoiding Retirement”

  1. 1 Christina July 24, 2013 at 3:58 am

    Thank you for this life-affirming post!

    My 92 y/o mother, and the rest of the family, just lost her (early 60s) MD to retirement. I suspect it had more to do with the…. well, with Obamacare and the new business strictures than with anything else. He was a wonderful, caring, physician. He saw most of the indigent people in need of medical care that traveled through the local charities of his county. He had a sign in his office that read (paraphrased from memory) “No patient shall be turned away due to lack of ability to pay”.

    The void he leaves is enormous! It hurts my heart to think of it.

    The business side of medicine can be brutal: the last time I was at his office, he had four staff members visible (nurses and office staff, not counting attorneys and CPAs, etc.) just for his one-MD practice. I understand that MDs have to make at least a living wage, and on one hand, I wish he had done what your Marc did, instead. Unfortunately, I can also understand why he would not have wanted to affiliate with the local hospital system, which I hear is onerous indeed.

    I am always astonished when I hear of physicians retiring… somehow I cannot imagine why one would retire from healing work—business, now THAT I can imagine retiring from. Oddly, I am even more astonished when I hear of alternative medicine practitioners retiring. The first time I was told that one of my elders was making plans to retire, it gave me a Zen Moment that lasted the entire day, and indeed echos even now 15 years later. How do you quit being a healer? (I didn’t know They LET you…) Unless you never were a healer in your own mind in the first place… if it’s just a job, maybe you treat it as such. How sad!

    Thank Dr. Marc for me, please. Tell him he gives me hope.

  2. 2 Eileen Burns McNally, RN July 24, 2013 at 1:11 pm

    What a man…what a doctor…
    I am a retirement age nurse who plans never to retire as well. I am making myself more healthy in a more conscious manner than before and feel that life is just beginning in so many ways.
    I, too, will always be a nurse. It is part of my soul and the core of my being…I love what I do and find tremendous satisfaction in helping my patients attain health..
    Best wishes, Dr Marc…may you always be blessed..

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


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