作者:yunmu  于 2019-5-5 06:50 发表于 最热闹的华人社交网络--贝壳村


为什么医生不喜欢退休 (翻译)

Why doctors don’t like to retire

The past decade has seen an enormous upheaval in the practice of medicine. The private independent medical practice is in danger of extinction. Management overhead and red tape has skyrocketed due to government regulations and private insurance and pharmaceutical benefit rules. Added to that are multiple electronic medical records that need to be implemented, vary from one hospital to another, and often do not “talk” to one another. Thus, it would seem obvious that physicians are leaving their practices in large numbers. Perhaps. Perhaps not.


 An April 5, 2017 Time Magazine article broke down retirement rates by professions. They charted the percentage of workers still working after age 65. It seems that this is an accurate yardstick to measure the issue.  Topping the list of working professionals least likely to retire after 65, were tax preparers. 14.6 percent them were still working at age 66 and beyond. Pharmacists were at the bottom with only 4.3 percent. Although not near the top, physicians and surgeons were still in the top third at 8 percent.  So why then do so many physicians resist retirement? I believe there are multiple reasons.


 For many physicians, medicine is the only employment they have had in their adult life. Despite drops in salaries and autonomy, they still enjoy above-average wealth and income and may fear loss of this post-retirement. I fully retired three years ago. I have friends who still work and others who don’t. Illnesses play a role for sure. Some have few hobbies and fear boredom. That is a reasonable concern. Most of us are used to being respected by the public and inwardly fear that loss as well. My father, who had no hobbies, worked as an internist up until almost the day he died. Certainly, I am called “mister” a lot more these days than “doctor.” For me, however, there seemed to be a loss of “purpose.” Victor Frankl’s famous 1946 book Man’s Search for Meaning has a great quote that goes something like this: “Your work is not your worth.” This is a concept that is difficult for many of us to accept and grasp.

对许多医生来说,行医是他们成年后的唯一职业。尽管现在医生的收入和自主权【相对】有所下降,但他们仍然享有高于平均水平的财富和收入,并可能担心这些在退休后会减少。我三年前就完全退休了,我的一些朋友已经退休了,部分是因为疾病。但是另一些朋友仍在工作,有些人没有什么爱好,害怕退休后无聊。这个担忧并非不合情理。我们中的大多数人已经习惯于受到公众的尊重,内心害怕失去这种尊敬。我父亲就没有任何业余爱好,直到他去世的前一天,他还在内科行医。当然,我现在被称为先生比被称为医生的次数要多得多。对我来说,似乎失去了初心。维克多·弗兰克尔在1946年出版的著名著作《人探求的意义》中有一句名言,似乎是这样写的:你的工作不是你的价值 这是一个我们许多人难以掌握和接受的概念。

 Although I spent most of my career in private practice, I always felt like a teacher. I would teach my patients, younger doctors joining the practice, nurses, and pharmacists. That all disappeared as soon as I retired. I write and read a lot. I like to fish and practice tai chi. I will soon become a tai chi instructor perhaps filling one need. A good fishing friend of mine who retired from sales and many years on the road and in the air, doesn’t understand why doctors are reluctant to retire. I don’t want to be judgmental, but for him he had a job. For many doctors, we feel as if we have a calling. For me, every other January is decision time. That is when my Florida medical license is up for renewal. Although the likelihood of me returning to active practice is low, the mere act of giving this up would mean that there really is no going back.


 Lastly, the act of retirement brings into hard focus that this is indeed the “last stage” of one’s life. Although we deal with the death and dying of our patients daily, when it is “our” death and dying, well, that is a different matter. The hassles of corporate and industrialized medicine will continue to affect physician retirement rates. However, for many of those in the profession, the idea of life without medicine is just too scary to contemplate.


 英文原作者David Mokotoff是一位心脏病专科医生,他在自己的网名David Mokotoff上发表博客。原载KevinMD.com

 Yunmu翻译后记:作者抱怨的医生要花费很多精力在电子病历上,而每个医院的电子病历各不相同,往往彼此不能交流。其实这也是目前大多数医生的抱怨。14年前在电子病历仍然处于初级阶段时,就有人提到过这个问题。 大多数人同意:与其将来要写大量程序让来自不同公司不同格式的电子病历彼此交流,还不如建造一个统一的全国性的电子病历让所有医院使用来得省钱。有人按照当年的美元价值来估算,在美国要建成一个统一的电子健康报告系统需要当年价值1560亿美元的投入和5年的时间,再加上每年相当于当年480亿美元的运营成本:“One study estimates that creating one in the United States within 5 years would require $156 billion in capital investment, plus $48 billion in annual operating costs” Easing the way for the electronic health record Feb. 2007 Vol. 2 Num. 2.。但是政府拿不出这笔钱啊。









发表评论 评论 (5 个评论)

1 回复 borninheaven 2019-5-5 13:12
废话, 要赚钱
1 回复 yunmu 2019-5-5 23:54
borninheaven: 废话, 要赚钱
如果说收入是美国医生选择学医的一个重要因素并不为过。然而不少医生还是追梦的。例如从华盛顿DC到波士顿的东岸是医生收入最低的地区,但是美国最好的医院大多集中在那里, 医生密度也最高。至于退休,可能收入的影响不是很大。
回复 borninheaven 2019-5-6 23:48
yunmu: 如果说收入是美国医生选择学医的一个重要因素并不为过。然而不少医生还是追梦的。例如从华盛顿DC到波士顿的东岸是医生收入最低的地区,但是美国最好的医院大多集
回复 yunmu 2019-5-7 06:38
borninheaven: 世事总是有例外的。东岸医院多是因为医学院多,市场供需关系,并非东岸医生觉悟高
回复 borninheaven 2019-5-7 06:58
yunmu: 你说的情况也存在,但是现在交通那么发达,年青人要离开东岸医院还是很容易的。我想他们更多的是想利用东部医院丰富的资源来寻找改善健康世界的方法     [e

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