Hashem said, “My breath shall not abide in man forever, since he too is flesh; let the days allowed him be one hundred and twenty years.” Genesis 6:3
Sixty-seven is the mandatory retirement age for most Israelis in public institutions, including that for doctors in community health centers and hospitals (but not for prime ministers or Knesset members). That fact is upsetting to many physicians who want to continue working, at least part-time after reaching that key birthday.
Doctors at the Western Galilee College in Acre and the Galilee Medical Center in Nahariya recently conducted in-depth interviews with male and female physicians around the country who had reached and passed their retirement age. The youngest, a gastroenterologist, was 67, while the oldest, an ophthalmologist identified as Anna who retired at 67 and is now aged 86. All of them, who had been senior employees as hospital department or unit heads or in one of the four public health funds managed somehow to find work treating patients after going on pension.
Dr. Shlomo Manor and Dr. Roy Holland published their findings in a recent issue of Harefuah, the journal of the Israel Medical Association.
“Retirement is a tipping point and a significant change in lifestyle for people who have worked for most of their lives,” they wrote. “Life without work, a social framework, employment, contentment and a sense of being needed are a blow to the self-image and identity of a person who feels that retirement was imposed on him only because he reached a certain age specified in the law.”
The authors decided to look into the post-retirement tendency of Israeli doctors to try to continue working in various public frameworks. Among the subjects included in the interviews was whether they had prepared themselves for retirement, what their fears were about having to stop work, what they were doing after going on pension, why they decided to continue working and how long they thought they would continue to work. Those interviewed were identified by their first names.
Given the fact that there is a growing shortage of physicians – especially in certain specialties and in the periphery of the country due to large-scale retirement by former immigrant doctors who arrived three decades ago from the former Soviet Union – the matter is an important one.
Many doctors have spoken about the fact that in the field of medicine, the experience is one of the most important resources. Retirement at 67 – at the physician’s professional peak – is perceived as forced retirement. In addition, they wrote, all the doctors spoke about their fear of a drop in their standard of living and monthly income due to the low pensions to which some of them are entitled; those who did not work overtime or on weekends and holidays for many years ended up with a lower pension rate.
In addition, the loss of halting their work is not only material but also social and emotional. Since medicine is so demanding in terms of hours of work, many of them failed to develop leisure-time activities or other alternatives to their work during their long careers. Since being a doctor is so central to their identity as individuals, retirement may also be an affront to that very identify, the authors suggested. Many of those interviewed said they wanted to continue working to keep busy, feel that they were contributing, have social ties, preserve their good health and maintain their routines.
Other studies of people who retired from other professions and jobs have shown that those who continue working at something are healthier, enjoy a higher quality of life, are more active mentally and physically and more satisfied than those who stop working.
The average longevity rate in Israel today is high – some 84.2 years for women and 80.7 years for men. This means that many doctors are sent home 13 to 17 years before the end of their lives.
Going to work at another job after a doctor retires is called “bridge employment” because it bridges their time until they finally decide to call it a day.
According to data of the Health Ministry in Jerusalem, of some 18,000 specialist physicians registered, 24% of them are over the age of 65. The rates in the US, Canada, Australia and many Western European countries are similar.
Most Israeli physicians are employees rather than self-employed, unlike those in the US, so they are less free than their American counterparts to continue working after retirement age.
The survey in Harefuah found that 75% said that if they had not reached 67, they would certainly not have wanted to retire. Sixty percent of those interviewed said they did not initiate retirement but that it was forced upon them. “I suppose that if they had asked me to stay another one, two or three years, I would have stayed. It was my life!” said “Dr. Tony.”
“A woman doctor who was forced to retire but found a job at a private hospital said” Suddenly not to be a doctor anymore? It was terrible. If you retire, you feel that you are losing your identity. But I am continuing… so it’s OK,” said “Dr. Dana,” an anesthesiologist.
Stopping work as a surgeon because employees fear his or her hands are less steady is even more difficult. “What I’m doing now is not the same work I was used to. Now it’s a relatively low level, a different kind of work, doing simple things we used to give to interns. Today I am not involved in any decisions that I was used to taking,” said “Dr. Leon.”
Many of those interviewed bemoaned the fact that their decades of experience were being wasted as they were not consulted much in their new jobs by younger doctors at the workplace.
Finally, complete retirement was regarded, especially by the men, as a blow, because they wouldn’t know what to do with their time. For the women doctors, busy with homemaking, husbands and grandchildren, the prospect was seen as less catastrophic.