Tuesday, 7 September 2010

Changing attitudes to retirement in medicine and academia

The idea of retiring on a generous pension after about 40 years of 'work' seems likely to have become obsolete by the time I get the opportunity; but even without considering such things, attitudes towards retirement from medical practice changed incredibly quickly between the time of my graduation from medical school in 1982 and the time of my 25th reunion.

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Up until the 1980s it was very difficult to get doctors to retire - mostly they went on and on working, unless or until they were almost-literally levered-out from their surgeries and offices.

But by 2007 it was common for doctors in their late forties already to be talking about how much they looked forward to retiring, and wishing that they could retire already.

A great deal had happened in that quarter of decade. One thing of relevance was the feminization of medicine, with women becoming a majority of graduates (my generation was roughly at the point when equal proportions of women and men were graduating in medicine - since that point it has been an increasing majority of women). A smaller proportion of women than men have a strong sense of vocation.

More important has been the bureaucritization of medicine and the take-over of medicine and health services by managers (and their puppet-masters - the politicians).

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But why this difference?

I don't think it was due to greater virtue, altruism, or sense of duty among the older generation.

But I do think there were a higher proportion of doctors who cared about, were devoted to, *their subject*, in an abstract sense. More doctors with a sense of vocation, that is.

Some of this was due to sex differentials. But another major factor was status. In 1982 it was a very high status thing to be a doctor - doctors were given a tremendous amount of prestige, and themselves felt very proud to be doctors. So, people wanted to stay working as doctors (even if at a reduced committment), to stay active in the profession - since it was much more prestigious to be a practicing doctor than a retired doctor.

In other words, a sense of vocation was supported by status; and when status was bound up with a profession, a professional was more likely to perceive himself qua professional. His identity was bound-up with his work.

This fits with the fact that quite a lot of the doctors who were most reluctant to retire were exceptionally conceited and arrogant types, who were obviously reluctant to hand over the reins of power. They apparently wanted to *be* doctors more than they wanted to *do* medicine.

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Something pretty similar applied to academia as well - indeed, from what I could gather, many academics in the arts and humanities published very little during their years of employment; but did (or at least completed) their best known work several years after statutory retirement age.

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Yet now people are apparently desperate to stop medicine or academic pursuits as soon as they can afford to.

Clearly, since the bureaucritization of life which has proceeded so far in the UK, the professional classes (including managers themselves - who usually *hate* their work) have lost all sense of vocation, are unrewarded by status, and therefore feel that they are working only for money and are giving-up nothing important in retiring.