The economic, social, and political climate of our world is volatile and can be very challenging to navigate. This also holds true for the specific microclimate most of us dwell in professionally, namely perioperative medicine. Given this, I do not think it is a bold assumption to state that almost all anesthesiologists, at one time or another, have contemplated walking away from the profession. This month, we have the opportunity to hear from Dr. Dennis McCarthy, a physician who has indeed “hung it up” – he retired in 2022 after a long and successful career. What is inspiring in his story is that Dr. McCarthy is a thoughtful, prudent individual who left our profession on his own terms, following a logical exit strategy laid out well in advance. His words of wisdom should resonate with all of us, regardless of age or stage of career.

Dennis, thank you for agreeing to share your experiences with ASA members. Can you give a summation of your career and capsule biography?

Zach, thank you for that kind introduction. I went to college at the State University of New York (SUNY)-Buffalo and attended medical school at SUNY Downstate College of Medicine. I met my wife, Karen, there, who was a year ahead of me in school. We married toward the end of my third year. After finishing my anesthesia residency (also at SUNY Downstate), my wife and I moved to Jacksonville, Florida. We have two adult children: a son, Caleb (a cook), and daughter, Annamarie (a hospitalist), who were both born in Jacksonville. I worked in private practice for about 28 years. Much of the time, I personally provided anesthesia care. We also employed the care team model, which proportionally increased as time went on. I served in various leadership roles, including medical director of a surgery center and chief of our group. Over the years, I also went on over 20 short-term medical mission trips. Many involved directly providing anesthetic care; on others, I did primary care alongside my wife. We were blessed to be able to bring our children on many of these trips. In 2017, I entered the academic sector and joined the anesthesia department at the UF College of Medicine (COM)-Jacksonville. The people there are great, and I have particularly enjoyed working with the residents.

When did you first think about retirement?

Fortunately, I began thinking about retirement shortly after starting practice. I knew that I had to make sound financial decisions to prepare for the day when I would no longer have a paycheck. Usually, I was able to contribute the maximum amount allowed to my retirement plan. My wife and I also saved via investment in taxable accounts.

What factors were most crucial in your decision to retire?

We all know one must be financially ready, but I feel it is equally (if not more) important to be prepared for retirement mentally, emotionally, spiritually, and socially. I feel that I am retiring to do something else, not simply stopping work. Anesthesia is a stressful profession, but it is also rewarding. I am satisfied with my career and am happy that I am able to retire before being asked to leave. No one has asked, “Don’t you think it is time for you to retire?” The on-call responsibilities and weekend work strongly influenced my decision to stop practicing now. It takes me longer to recover from a night without sleep than it used to. Another important factor is that my wife retired from private practice over a year ago. She still runs the free volunteer medical clinic for the homeless that we started over 30 years ago at the Jacksonville City Rescue Mission.

What was your exit strategy, or master plan?

My plan included having the finances to support us through a long retirement. My wife and I both had parents that lived into their 90s (longevity risk). Our savings were sufficient to last that long, so I began looking at the other aspects of retirement. We are active in our church and have plenty of interests outside of work, so I felt ready to pull the plug. Since it is often difficult to hire physicians quickly, I gave my department six months’ notice of my retirement. Not long after putting in my resignation, our department chairman asked if I could continue to work on a PRN basis due to an ongoing staffing shortage. Right now, needs are high, so I give him the days I am available, and I end up scheduled for about 20-30 hours per week (when I am in town). This has been a great transition, without call or weekend work required. Literally the day after I retired from full-time work, my wife and I went on a seven-week trip to Europe. It was a great way to start the next phase of our lives.

How did you approach the financial analysis of no longer working?

I looked at how much we spent in 2020 and 2021. Since we do the majority of our spending with credit cards (to get rewards), it was simply a matter of compiling the year-end statements. Any other expenses paid by check or electronically were then added to the total. Additional information needed was calculation of the assets we had available to support our retirement spending. This includes investments inside and outside of retirement accounts and a residential rental property. I plugged this information into some online retirement calculators that helped me to see if my plan was on track. I specifically used cfiresim.com, firecalc.com, and the retirement planning tool at Fidelity. These all indicated that financially I was ready to retire. Even after the market downturn, our investments equal about 30 times what we want to spend from them each year. Our investments should be 35 times our spending from them once I start taking my Social Security benefits.

At any point, based on economic or other factors, were you concerned that your plan or timeline was disrupted?

This past year, not long after tendering my resignation, the stock market started going down, inflation was going up, and interest rates were rising. This did cause concern. A down market at the start of retirement (sequence of returns risk) is what can make you run out of money before you run out of time. You are spending your money and also depleting the amount available to grow/appreciate after the market recovers. The retirement calculators are generally based on historical data. As we know, past performance is no guarantee of future results. Since my plans included some padding (and also we were comfortable reducing spending if needed), I felt that we could move forward into retirement. In addition, our home equity is not included in the assets supporting our retirement spending – we can tap into that if needed. We have already downsized into a condo and do not have a mortgage. My wife recently started her Social Security benefits, while I will wait to claim mine until I am 70 years old. I used opensocialsecurity.com to help confirm I was making the right decision. Delaying the start of my benefits will help if inflation stays elevated.

Do you have advice for ASA members contemplating the end of their careers, and also for those just starting their careers?

As you approach the end of your career, it is important to have planned what you will do with your time that will give your life meaning and satisfaction. This will be different for everyone but can include volunteer work, being active in church or civic groups, travel, or spending time with friends and family.

For those starting out, it is important to remember that you too will one day retire. The money you save at the beginning of your career is important since it will experience years of compound growth. You need to save at least 25 times (some say 30-35 times based on current conditions) the amount you will spend each year (minus Social Security benefits, rental income, etc.) based on what is called the Trinity Study 4% Rule (AAII 1998;10:16-21). Once in practice, if you do not ratchet up your spending dramatically, you will save more and also reduce the total dollars needed for retirement since you have established a lower level of annual spending needs. Finances aside, remember it is important to maintain outside interests that can keep you fulfilled after you stop practicing.

What activities are you pursuing now that you are retired?

My wife and I do a lot of traveling. We anticipate that as we get older our ability to travel will decrease, so we are consciously maximizing this while we can. Most of the time, I do the planning myself. I enjoy doing the research for the trips since it allows me to design them around our interests. We usually have at least one trip planned at any given time.

I have been doing more reading and exercising, including long walks on the beach, which is very close to our condo. We also look forward to helping care for our grandson, who is due in the spring. Our daughter fortunately lives nearby.

What did you most enjoy about practicing anesthesiology? And what did you find unpleasant?

Anesthesiology is an intellectually stimulating profession. It has been a pleasure to work at UFCOM-Jacksonville where we often discussed difficult cases or management challenges. I enjoyed the patient contact. It was an honor to help people through a difficult time in their lives. In obstetric anesthesia, sharing in the joy of the expanding family was rewarding. I will not miss the stressful times when you have to deal with a patient who is hemodynamically unstable or has an unanticipated difficult airway. The night and weekend calls were also not pleasant. These days, I enjoy waking up when I am done sleeping, and not to the sound of an alarm clock.

Any final thoughts for readers?

You will retire someday. The sooner you start planning for it, the better prepared you will be when that day arrives. You can have someone help make many of the financial decisions that are needed, but only you can take the steps necessary for your retirement to be successful on the spiritual, emotional, and mental levels. In many ways, the financial part is the easiest. Don’t neglect the other aspects of retirement.