Retirement Retirement and the afterlife Rural GP locums & other issues John Mackenzie, 2009

Monash 1966 (inaugural graduation year)

Monash 1974

Working Life Intern & RMO W’Bool & ’76 SHO/ reg Northampton & QVMC -> ‘80 GP Portland -> ’83 S/reg neonatology and O&G, NETS and assistant to medical director, Mercy –>’88 Retirement GP Tyabb -> May 2008 : “Retirement”.

Usual retirement model Retire at 65: Work full time up to age 65, then suddenly stop ! Problems: - Unfair if ill health or death. - Sudden void (stress = loss of spouse). => GPs have an alternative..

semi-retirement Early semi-retirement Start spending the kids inheritance When: - you and your spouse still young and fit - no mortgage stress - no school fees => Can continue in semi-retirement past 65.

Book: “The 4 Hour Workweek”

Tax issues Less work (1/3 rd work) = lower tax rate (½ income) Over 60, salary sacrifice 100% into super (taxed at 15%), and draw a “pension” from your fund (tax free). Small Business Exemption from CGT (eg. on sale of freehold).

Work options in semi-retirement Continue working in same general practice, but work less, eg. cut back to 2 days per week Hospital A+E shifts Aged care from home (Dr Charlie Arter) Special interests: drug and alcohol rehab, skin, travel medicine After hours GP co-operative (MediCentre) Civilian MO in the ADF (Cerberus) GP Division/ Network (board, subcommittees) GP locums – urban, overseas (Ireland), rural

Rural GP locums (Apollo Bay) Mainly normal general practice + run small hospital - acute medical in-patient care (4 beds) - emergency medicine - simple radiology  Don’t need to be “super-Doc”

Improved rural GP support Ambulance officers and nurses better trained. Phone support from ED consultants, NETS, PETS, ARV, and “hotlines”. Mobile phone Internet Laptop computer – library of clinical support

The joys of rural GP locums Delight of being needed and appreciated. More organic pathology (“real medicine”), less social work and paperwork (“bullshit”). No responsibility of running a business, employing others, partnership problems. Travel and accommodation paid by employer -> cheap family holiday. Well remunerated.

Typical rural GP locum

Rural GPs need you Critical shortage of rural GPs => desperate need for locum relief to prevent rural GP burnout.

Burnout Rural GPs ageing, dwindling Outer metropolitan GPs overworked Patients stressed

Remedy Multivitamin ? Naturopath’s “detox” diet ? Self-medication with EtOH ? … NO => Less work, more leisure time.

enjoy life More time to enjoy life …

Key messages Don’t leave it too late to enjoy life. burnout Avoid burnout. semi-retirement Consider semi-retirement whilst still young, fit and able.

“I’m outa here. You beauty”