Sunday, February 07, 1999
During a densely packed four hours Friday, each of seven different presenters in Instructional Course 291, "Planning in Your 30s and 40s for Life After Orthopaedics" reiterated this message. Course instructors sketched the future landscape for nearly 200 attendees, touching on predicted demand for specialty care in the next decade, strategies for accumulating assets and deferring taxes and how to maximize the joys of retirement years.
One reason for offering the course, said William J. Kane, MD, PhD, moderator, was an American College of Surgeons' survey that found only 43 percent of surgeons had given any thought to retirement before the age of 50. Accordingly, he assembled a panel of experts in financial planning, tax law, estate planning, insurance and public health management.
The age of 30 or 40 is not too young to start taking charge of one's retirement, said Dr. Kane. The 76 million baby boomers born 1946-1964 can't expect the same good fortune as their parents enjoyed: a healthy Social Security system, a runup in real estate values during the inflationary 70s and solvent pension plans. The future of retirement will be much different for boomers, he said. People will work longer and harder, and - being boomers - will probably handle retirement in an idiosyncratic way, as they have everything else.
Retirement must be viewed within the changing context of medicine, said Thomas A. Einhorn, MD, professor and chairman, department of orthopaedic surgery at Boston University School of Medicine. The good news, according to Dr. Einhorn, is that orthopaedists "still see the lion's share of initial patient visits."
The bad news comes from results of a RAND study commisssioned by the Academy, "Demand-Based Assessment of Workforce Requirements for Orthopaedic Services." RAND told us "what we didn't want to hear," said Dr. Einhorn, namely, that at the present graduation rate, the U.S. will have 4,000 surplus orthopaedic surgeons by the year 2010. Marketplace competition will increase, and program directors are already looking at making hard choices to reduce numbers of residents while maintaining quality training and patient care.
William Collins, MD, Atlanta, had some sobering comments about the use and abuse of insurance. Referring to his medical practice life as "Before Embezzlement and After Embezzlement," he discussed necessities of adequate disability coverage (you're three times more likely to become disabled as to die prematurely); choosing term over cash value insurance ("buy term and save the rest"); and the advisability of frequent coverage reviews.
In a straightforward presentation, Mark Cherniak, CFA, and director of individual portfolio management for Norwest Private Client Services in Minneapolis noted "How you invest is more important than what you invest in." What works, he said, is intelligent planning, and demonstrated strategies for rationally composing an investment porfolio.
Cynthia Hinds, MFS, of Lake-wood, CO quickly reviewed retirement planning strategies, and noted that surgeons should assemble a team of financial advisers, including an attorney, insurance agent, broker, financial consultant and CPA. One should review retirement plans on a regular basis, she said, and suggested deferred compensation as one strategy to postpone paying taxes. "The deferral of income tax is one of the most powerful asset-building techniques that you have," she said.
Robert L. Veninga, PhD, professor in the School of Public Health at the University of Minnesota in St. Paul, supplied the final piece of the retirement prescription. Along with a financial plan for enjoying retirement, you also need a psychological strategy. His critical incident study of 125 retired people revealed that although most people are happier in retirement, they experience a steep decline in satisfaction at about one year post-retirement. This is the time when they had "done all the things they had wanted to do," and were wondering, "what now?"
It's possible for the retirement period to be the "renaissance of your life," he asserted, if you also take these steps in your 30s and 40s: develop strong relationships with those you love; nurture your friendships; develop both hobbies and avocations; live a balance life, taking time for fun as well as work; and keep an open mind and sense of humor.