RetirementRetirement 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

• S/reg neonatology and O&G, NETS and assistant to medical director, Mercy –>’88

• GP Tyabb -> May 2008 : “RetirementRetirement”.

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-retirementsemi-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 (1/3rd 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

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.

BurnoutBurnout

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.

More time to enjoy lifeenjoy life …

Key messages

Don’t leave it too late to enjoy life.

Avoid burnoutburnout.

Consider semi-retirement semi-retirement whilst still young, fit and able.

““I’m outa here. You beauty”I’m outa here. You beauty”