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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 - 1975 & ’76 SHO/ reg Northampton & QVMC -> ‘80 GP Portland -> ’83

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retirement and the afterlife
Retirement and the afterlife

Rural GP locums & other issues

John Mackenzie, 2009

working life
Working Life
  • Intern & RMO W’Bool - 1975 & ’76
  • SHO/ reg Northampton & QVMC -> ‘80
  • GP Portland -> ’83
  • S/reg neonatology and O&G, NETS and assistant to medical director, Mercy –>’88
  • GP Tyabb -> May 2008 : “Retirement”.
usual retirement model
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 ..

early 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 .

tax issues
Tax issues
  • Less work (1/3rd 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
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
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
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
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.
rural gps need you
Rural GPs need you
  • Critical shortage of rural GPs

=> desperate need for locum relief

to prevent rural GP burnout.

burnout
Burnout
  • Rural GPs ageing, dwindling
  • Outer metropolitan GPs overworked
  • Patients stressed
remedy
Remedy
  • Multivitamin ?
  • Naturopath’s “detox” diet ?
  • Self-medication with EtOH ? … NO

=> Less work, more leisure time.

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