1. Simone, Joseph V. MD

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It doesn't happen often but ideas for columns occasionally just drop in my lap. Some ideas never go anywhere because I know too little about the topic or am not impassioned by it. But I recently received an idea that intrigued me.

JOSEPH V. SIMONE, MD... - Click to enlarge in new windowJOSEPH V. SIMONE, MD. JOSEPH V. SIMONE, MD, has had leadership roles at St. Jude Children's Research Hospital, Huntsman Cancer Institute, Memorial Sloan-Kettering Cancer Center, the University of Florida Shands Cancer Center, the National Comprehensive Cancer Network, and the National Cancer Policy Board, and has served on the NCI's Board of Scientific Advisors.His

The idea for this column came from married friends of mine who are beginning to contemplate retirement a few years from now. One is a medical oncologist and her husband heads a model supportive care program in a cancer center. In a recent email he posed the following question: "What is the healthiest way to cope with reduced social status once one retires or takes a lower-pressure or lower-status position?"


My qualifications for responding are: (1) I have personally gone through this exercise; (2) I have had numerous conversations with colleagues who are going through this experience (though they never posed my friends' question so directly); and (3) I have watched many academic retirees fail to prepare adequately for the changes wrought by retirement, or even semi-retirement.


So here is the scenario: Dr. Smith undergoes excellent training and builds a career doing research, teaching, and providing patient care. She works hard and becomes very good at what she does and is rewarded by promotions, increasing stature, and more responsibility for leading programs or departments. She is happy in her work, but she is growing older and would like to retire while she is physically and mentally able to enjoy it. She will have a decent pension and will not need to work to feed her family. Her kids are grown and financially independent (sort of, are they ever?). Her husband is in the same boat and would like to retire, as well.


So she and her husband started asking and discussing questions such as:


* When do we retire? Calculating the optimal financial status and completing or passing on to a colleague any professional projects that are important can help decide this fairly easily.


* Where do we want to settle? This depends on family issues and past experience and with some give and take it can also be settled easily, especially if the next question is also considered.


* What do we want to do in retirement? In my pre-retirement discussions with my wife, she constantly reminded me "retirement is not a long weekend"; it is 24/7/365 in duration. I have a colleague who retired to play golf with his wife; they moved onto a golf course and did it happily for years, but he is in the minority. Even serious hobbies can get stale and most professionals have been driven to work hard and stay occupied and they get bored easily.



One solution for them is to take advantage of what they do now and find a part-time activity that takes advantage of their years of experience. I chose consulting for cancer programs and centers because I had already served (and still serve) on many cancer center external advisory boards. Other colleagues of mine join biotech or pharmaceutical companies as board members or consultants. Other colleagues have taken the not-for-profit road and make a substantial voluntary commitment to work with a charity, hospice, or school. Some do both part-time voluntary and paid work. Starting a completely new career or business from scratch is possible, but very difficult unless one has a base to start from. And that may not allow for sufficient down time that most of us want in retirement.


So now we circle back to my friends' question: What is the healthiest way to cope with reduced social status once one retires or takes a lower-pressure or lower-status position? When I was planning retirement from academia I had several serious and lengthy conversations with myself. I identified what I believed to be the likely fallout from retiring and how I should deal with that over time; here is what happened.


1. The day I packed up my things at my office and walked away, I feared that a significant part of my professional stature would be left behind. I was concerned that people would forget me and no longer call me for advice. But I had a substantial body of work, a good track record, and a personal reputation that would provide enough stature for me to deal with any insecurity. There was some risk, but I have always been able to deal with some risk and my wife Pat was with me 100 percent.


2. When I walked away from that last academic job, I didn't look back. Whatever course the institution chose was no longer any of my business, even though it might have been painful to watch. Though I remained friends with colleagues, I was off the site, and thus out of mind. I expected that. I didn't get involved in institutional issues and deliberately avoided learning any details of progress or problems.


3. I continued serving on external advisory boards and national committees to stay in touch with progress in my field so my consulting advice would be current. And once people knew I had time on my hands, I was increasingly asked to participate in projects.


4. My consulting work grew, and I learned from friends and colleagues how to be a useful consultant. At first I took almost any job that came along but soon learned which ones I should not take-e.g., a hopeless situation or something that was just not interesting. Since I had a good pension and my wife and I live modestly, any money I earned from consulting was not critical for my family's survival (but it did help with the family trips).


5. About two years after I retired in 2001, I founded the Quality Oncology Practice Initiative (QOPI) with ASCO. I recruited other volunteers to invest their time in building the program. This had my attention for a decade and it was fun and gratifying work.


6. At about the same time, I was asked to write this column for OT-The column you are reading is the 197th in the series.


7. In the years since retiring, I took my family to Italy three times (13 of us the last time) and to countless beaches, where I could enjoy their company and my five grandchildren (who are the joy of our lives). Helping to sustain a close, happy family, which we are blessed with, was the reward of retirement that I cherish most.



I learned many things in this process. I learned that I thoroughly enjoyed the opportunity to try new things outside of my comfort zone with new and stimulating challenges (e.g., my column and QOPI.) The main revelation was that I realized that sustaining my peak professional stature was not my highest priority-not even close. My priorities were family, trying to do good things for medicine and people in need, and doing things I enjoyed even with no financial compensation.


I suppose one might say that sustaining a passion for the most important things in life was the best way to build a successful retirement and retain one's stature where it counts.