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After a long and rewarding career as a family practice physician, Dr. Bill Ventres discribes his plans – financial, emotional, physical, and mental – for retirement. He explains why it’s so important to understand that just because you retire – doesn’t mean you have to be tired.
And, if you find yourself having difficulty navigating your transition, a coach may help. Visit us today at www.mymdcoaches.com
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Bill Ventres is a seasoned family physician and medical anthropologist. Clinically, he has more than 30 years’ experience as a community-based family doctor working in both in ambulatory and hospital settings. His work has focused on the care of underserved and minority populations in safety-net clinics and corrections health settings. Outside of clinical practice, he has been a leader in developing family medicine internationally, investigating communication between physicians and patients, and using qualitative methods to explore practice-oriented research questions. He has written extensively on topics related to social determinants of health, ethics in generalist practice, and social accountability in medical education. He has been awarded two Fulbright Senior Scholarships to teach in medicine and public health, one in Venezuela and the other in El Salvador, and has been a visiting professor at the Nelson Mandela University in Port Elizabeth, South Africa.
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Access the Show Transcript Here
[0:00] You know, as we get older, it’s important to keep reaching out to folks who are younger and younger.
And that keeps us active.
It keeps us hearing new voices. It keeps us churning, churning in a sense, moving, not becoming stagnant.
There are times in our lives that change the way we see the world.
Navigating these challenges can take insight, trusted confidants, or even a coach.
Let’s explore those moments.
In this companion podcast to Rx for Success, we will discover ways to learn and write our own success stories together.
I’m Dr. Dale Waxman, a physician coach with MD Coaches, And this is Life-Changing Moments.
[0:55] Today, we’re talking with Bill Ventris. Dr. Ventris was our guest for RX for Success episode number 126.
There, he spoke reflectively and eloquently about what actually happens in clinician-patient interactions that makes them therapeutic. If you haven’t heard it, I really encourage you to listen.
Bill is also a close friend.
We were in residency together many years ago and have had many meaningful, philosophical, and connecting conversations over the years.
As many of those discussions were indeed life-changing for me, I wanted to offer you an opportunity to tap into one of them to perhaps pull out something helpful to you as you continue your life journey.
So our topic today is transitioning into retirement.
Bill, welcome to Life-Changing Moments. Thank you so much, Dale.
Let’s go ahead and get right into it.
You’re preparing for a new chapter in your life.
Tell us a little bit about that. Sure.
First of all, Dale, it sounds like you’re putting me out to pasture that I’m going to sit in front of the TV, plot myself down, watch it all day, or maybe golf all the time.
Well, that’s not what I’m intending to do.
I look at retirement for me as re-energizing.
I have some very exciting plans from my point of view to keep me going for who knows how many years.
[2:25] Great. Well, so, you know, it’s interesting you brought up this put out to pasture.
Personally, I have a little difficulty with that term because I also associated with this sort of put out to pasture and just sort of only do leisure things.
And for me, I really don’t do that well. That doesn’t give me much in the sense of purpose or meaning.
And so it sounds to me like that’s something that you’ve been thoughtful about, too.
Very intentionally. And that actually comes from my family of origin.
My parents actually around age 50 got divorced, not uncommon.
And my dad, who had been very active professionally, he was an attorney, very active professionally before the age of 50, the last 25 years of his life, he, you could see him become smaller, so to speak, metaphorically.
On the other hand, my mom went back to school, got a job, advanced in her job, went into the peace corps in Haiti of all places.
Came back, worked with refugees for a while, wrote a book.
I have never read it. I have to be honest. It was never published.
It was some kind of geriatric love story.
It doesn’t matter until they both had about 10 years of physical decline at the end of their lives.
Lives, but before that, two different directions. and.
[3:52] Around age 50, I made a conscious choice to say, I want to blossom.
Adam Backer Yeah, yeah. So it sounds to me like you’re, you learned from your father what not to do, but learned from your mother what to do.
David Well, there were other things I learned from my father what to do. But in this case, you’re absolutely right.
Adam Backer Sure, yeah, sure. So, well, just, you know, let’s back up for just a moment. What is your situation right now? And then when are you planning to make this transition? David Well, so if you remember, I worked as a family doc in safety net clinics for about 20 years after residency.
[4:27] Then I lived in El Salvador for five years and I was teaching public health and medical anthropology in El Salvador. The last five years, I have been a clinician educator in the Department of Family and Preventive Medicine at the University of Arkansas for Medical Sciences.
I mostly work with medical students, but I also do some patient care, some direct patient care, and I supervise residents in the family medicine office.
Yeah, and that’s going to be coming to an end soon.
Seven months and 29 days, but not that I’m counting. Not that you’re counting. Yeah, I hear you. I was there as well.
It’d be interesting to hear about the plans, and I think what I’m most interested in is what the process has been like for you to design your life after you leave Arkansas?
[5:23] What kind of things have you considered as you’re designing that?
So in thinking about transitioning to retirement, as you put it, the things that came to mind were, one, I want to be physically, and let’s call it intellectually active, somewhere north of the neck, I want my brain to keep working.
And so in putting together a plan, it meant, or it means, or it means, because this is looking into the future, It means.
Continuing to do something on a daily basis, be physically active.
[6:00] I look at that as probably going back to Zumba.
I was very active in Zumba every day of the week, almost, uh, when I was in El Salvador before, oh, I think I might’ve mentioned I’m going back to El Salvador.
Uh-huh. So that’s one of the plans you’re going to be doing.
That’s one of the plans. So I’ll be immersing myself once again, in another culture, the physical part of it.
I want to do that again. I have had a exercise life here, but because to be honest, because of the pressures that are inherent in modern day medicine, I am not as physically active as I was in El Salvador.
It’s a different rhythm of life, let’s say. And then the thinking part or the keeping my mind active part, I’m actually planning on going back to school.
And there are several reasons for that.
One school is a place that there are lots of young folks.
I probably will be an outlier.
[7:04] But as one of our colleagues from residency said, you know, as we get older, it’s important to keep reaching out to folks who are younger and younger.
And that keeps us moving.
Active, it keeps us hearing new voices. It keeps us turning, turning in a sense, uh, moving, not becoming stagnant.
The other reason is simply that my speaking of Spanish is pretty good, but I need to improve my reading.
So I’m choosing a program in which I will be forced to read in Spanish.
I’m very excited about that because that’s the way to become involved in.
[7:50] Salvadoran life, not as an expatriate, but as a participant.
Uh-huh, yeah. You’ve obviously put lots of thought into this.
A lot of people don’t.
I don’t know if you’re aware of that, that what I hear from others is that they just sort of build up to this, you know, I’m going to do all these things after I retire.
They don’t necessarily put the plans in place for it to happen.
They just say, once I retire, I’m going to have all this time and I’m going to do all these things.
But they weren’t intentional about it like you are right now.
And so they find themselves sort of sitting and wondering.
And it’s tough to come to an abrupt halt after years of this, let’s just say the churn of of medicine that we both have experienced, right? So. It is challenging, yes.
Yeah, it can be challenging. And so along those lines, a lot of people who are like you and me, we’re clinicians, some of them still do some clinical work.
I was just curious whether that’s part of what you imagined yourself.
Will you still be doing anything around family medicine?
I’m talking to a gentleman next week about that.
So previously when I was living in El Salvador from 2010 to 2015, I’d come back to Oregon where I used to practice, and I’d work with the county healthcare system where I used to practice.
[9:17] Only then I worked in the Multnomah County corrections in jail.
[9:24] And, and that’s because they needed people to work there. I would take over for people so that they could leave and go on vacation and not have in the back of their mind, am I dumping work on my colleagues?
[9:38] So it was a win-win situation. Next week, I’m meeting with the head of the, the medical director of the jail system and we’re going to be working that out.
That serves two purposes.
One, it kind of keeps me sensing that I am a family physician and I have this professional identity as one.
The second part is, is that I think like many people, and especially with the downturn in the economy this past year, I’ll be honest, I have some anxieties and they focus about, well, how long am I going to live and how much money I have and will those Does mesh or will they not mesh?
So having a little extra income, I think that’ll go a long way.
It’s not so important in terms of the money.
That’s probably okay, but it’s with my worry about balancing my life expectancy with what’s in the bank.
Yeah. I mean, you’re bringing up something that we’re probably not going to go too deep into because I’m no expert in this, but this is a very, very common theme that I’ve heard.
[10:44] For people like, who knows if you’re ready to retire because you don’t know. It’s that, how long am I going to live? Our financial advisors sometimes calculate it out to about what your average life expectancy is. But so what if I exceed that? What other kind of expenses am I going to need? So yeah, it’s a real common thing. And I know some people delay and are pretty unhappy in their last.
Few years of their working life, non-retired life, because they have that anxiety.
The other part of it is that I guess I want to recreate myself. I want to move forward.
This is from my dad. He spent, I think, the last 10 years of his life just doing what you just talked about, going to work, doing the stuff, because he didn’t have any other perception of of what he could do.
[11:34] And I want to challenge that for myself. Beyond school, I have a dream and I learned this actually from my uncle.
I might take a little tangent. My uncle, my uncle lives in England and for 40 years, he has written a film script on a historical event.
Has it ever come to fruition? No, but it has kept him active, alive, engaged, meeting people in the film industry.
It’s been incredible. He’s 92 now.
I think he’s finally coming to the realization that this won’t happen in his lifetime.
His daughter’s taking up the mantle of being the, I don’t know, director, producer.
I’m not a film guy, but this has kept him engaged.
And I think it’s important to have some dream. And my dream is actually, I don’t know if you’ve ever heard of the Bellagio Institute or even in Arkansas, the Winthrop Rockefeller Institute.
These are places where people can go to have small group discussions about the common good, whether it be in Arkansas or whether it be around the world.
You might even think of it as a academic retreat center.
There are several of these. Another term for them are institutes for advanced sciences, but they’re all located in rich places.
[13:02] And my hope is is that I can work to help, Something emerge in central america, which is not one of the richest places in the world Especially focused around the countries of el salvador nicaragua honduras and guatemala, What now is called the northern triangle?
Hi, I’m Rhonda Crowe, founder and CEO for MD Coaches.
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[15:34] What came up for me as you were talking is this concept of meaning and purpose.
And that, you know, I think there’s data and I’m not sure I’m going to remember exactly the sources of this, but the Blue Zones book that was out some years ago, and I think the Blue Zones was looking around the world for people who had longevity. These are areas where people commonly lived. There’s a lot of people that lived to 100. This author was looking at it. What are some of the different components that made these populations live that long?
[16:14] As I recall, the main commonality between all of them was a sense of purpose because the diets were all different, their lifestyles were all different.
The other psychosocial factors were all different. Some people were not well off and some were, and some were in communities, some were not so oriented around community.
But I think the common denominator was a sense of meaning and purpose in life.
And so, you know, you’re what triggered this was you’re talking about your uncle, you know, his purpose is I got to finish this film script, right?
[16:51] The screenplay. That’s right. Yeah.
And so, you know, you have a lot, I mean, I’ve known you a long time, you have a lot of areas of interest.
If you had to kind of crystallize that to what brings meaning to you and what will continue to bring meaning to you as you go into this phase?
You know, when you ask about meaning, there are several aspects of my life, my family, my social life, my professional life, but I’m going to frame this in terms of my professional life.
And I’m a little embarrassed to say that it comes out of my work with patients.
My professional life, what has given me meaning is to allow people one by one, little by little, Nothing big, but allow people to have voice.
Now, that’s mostly framed around their concerns, their presenting problems, as we’d say, but.
[17:48] There’s something beyond the veil of the clinical presentation that I’ve tried to metaphorically touch because, especially in family medicine, people don’t just come with a headache or back pain or congestive heart failure or whatever.
They have a history, they have their family, they have their community, and they bring all that.
And my work has mostly been with people who are on the other end of the economic spectrum, in all honesty.
People who are marginalized because of the color of their skin, the language that they speak, or the place of their birth.
So the dream, and I will say it is a dream, and that dream becomes purpose.
That dream is to allow people in El Salvador, where my wife is from, to have voice in a world that doesn’t give them much voice, in a world that kind of puts them in a box, especially in relationship to the issues of immigration.
And I don’t think that’s fair.
[18:54] So if I can offer at least a few people that opportunity, I’ll be happy.
And that’s my purpose.
And that’s my dream. you That’s awesome. It’s this translation of, you know, the common theme there is giving people voice. Absolutely. Giving people voice and having transmit that into this next chapter for you is, it’s just a different, a little bit different of an audience. It’s the same people, just your professional role is a little different.
That’s right. And it’s a little bit more social instead of just one-on-one with a patient. Right.
It’s more bringing people together to share and to come up with their own dreams, perhaps, and their own dreams for their own communities.
[19:42] Yeah. Well, like other things, um, ever since I’ve known you, you’re one of the most reflective people I’ve ever met in my life and continue to, can you continue to be?
Um, I just want to summarize for our listeners a little bit.
But what I’ve heard is you’ve been very intentional in your planning for after these six months and 29 days or however many that was.
Seven months and 29 days. Is that well? I’ve got a month ahead of you.
Well, I’m not counting either. Yeah, yeah, I got you.
And what I heard, some very specifics were, go back to school.
I heard I’m going to get back into Zumba. My constituency of my work of giving voice is different, it’s more social than one-on-one patient care.
There may be some patient care involved as well. Continue to have bringing those skills to people as well.
So what I want to do is kind of shift, so it’s awesome, you’re intentional about this.
I think that’s a gift for our listeners to sort of say, be intentional about this because we’ve seen what can happen, you’ve seen in your own life what can happen if people are not intentional about this.
[20:55] And there is one other part of my intentionality is that I’ve already started to, in leaving my practice now, make transitions for my patients to other clinicians in my practice.
There have been other physicians who have left. This is common.
People come and go. They get older. They move on. Sometimes they move to a different position.
Academic practice, that’s not uncommon at all, but it frustrates me when they just dump their patients.
[21:25] And so I’m already starting that process six months in advance. And I’m really happy about that, especially for those special patients that we all have special patients, Dale, those who are challenging, those who might push our buttons. And I want to make it a little bit easier for those who follow me with my patience who are I think we got some coaching about that when we were residents.
I’m pretty sure we did some transitioning with, if I remember correctly, I might’ve done this another time, but I remember a lot of our patients went to team members that were under like second years and first years or incoming interns.
But I remember being intentional about who we were assigning people to and having those discussions with patients. I think we got that training way back when.
[22:21] We did. And that was, you know, 35, 40 years ago. But it doesn’t always happen everywhere.
No. So, the other reflection I had on that was when I was a medical student in Kansas, my very first rotation was psychiatry.
And I did it. I was in a community psychiatry setting in the middle of Kansas.
And it’s a two-month rotation. And I was with one psychiatrist and I followed patients with him, both day treatment as well as inpatient.
And I got to know several of the people that were in those kind of continuity relationships.
And about three weeks before the end of the rotation, like I’d only been there five weeks and three weeks before the end of the rotation, the psychiatrist said, now Dale, you need to start telling your patients that you’re going to be leaving.
[23:09] And I went, you’re kidding. Now he goes, no, this is very, very, very important.
And in psychiatry, the psychoanalytic joke is that for psychoanalysts, they spend a month.
[23:25] Preparing their clients that they’re going to be going on vacation. Then they take vacation for a month and they come back from vacation. They spend a month processing what it was like for the clients to be with us. So some of this was, I mean, I think some of that came to mind, but I’ve never forgotten that. I mean, he was absolutely right. This is not just about us and about dumping it on our partners. This is really about the patients. It’s like they are transitioning too. And we don’t do this very well, generally speaking. And there’s a lot of barriers out there that create that, like people’s insurance changing and all that kind of stuff.
I know that continuity is an important thing for you and me, so we’ve still sort of hold on to that.
And I don’t want this conversation to be about that, but it’s just a nice little digression.
But it is about me as well. And I learned this from a Canadian physician, Anne Macaulay.
I will have patients write in a little book that I will carry with me as I leave, just some final comments so that they can have the opportunity to express whatever they want to express and so that later on I will have the opportunity to reflect on those people who I hope I had something to do with moving them in some sense toward hell.
[24:46] Oh, Nate, that’s really awesome. I want to ask a few questions here, maybe a little bit more logistic that could help our, it could, as some of our listeners are reflecting on this.
Phase as well. So you’ve been reflective, as I was starting to say, about the things to do intentionally in retirement. And it sounds like you looked at what some opportunities were and sort of taken some opportunities. I was just curious what other considerations there were. Was there anything that kind of any barriers that you saw that or that you potentially see getting in the way of you being able to operationalize the things that you’re planning for yourself.
Things I considered were certainly, I have two children, two adult children.
[25:34] And in moving to El Salvador, it’s a little further away.
On the other hand, it’s closer from Arkansas to El Salvador than it is to where either of my children live.
One in Portland, Oregon, one in Washington, DC. So maybe that’s a mitigating factor.
But being close to them is something at least emotionally close.
If I’m not physically close is something that’s important. As we’ve all learned through COVID though, Zoom works pretty well.
There are some concerns and your viewers might think that I’m a little bit crazy by going to a place that has some challenges, both economically and in terms of gang violence, I’ll be honest.
But I’m not really concerned about that. I didn’t have problems before.
I’m not part of a gang. I don’t have any facial tattoos.
I’m pretty much exempt from issues. If I’m smart, you know, I could go quarter of a mile from where I’m sitting right now and find trouble if I wanted to, but that’s not my interest.
And then the other thing is, is that, and this is universal.
My mother-in-law lives in El Salvador and we’re going to be close to her.
That is a concern in some way.
[26:51] Uh, I love my mother-in-law and sometimes she drives me a little crazy.
So how am I going to manage that?
Now that has nothing to do with El Salvador. It doesn’t really have anything to do with retirement.
It does have something to do with family and families.
I don’t know, what was it that Tolstoy said? Families are different and they’re all interesting too.
Wherever that is, yeah, that’s great.
Good. Don’t quote me on that because I didn’t quote Tolstoy very well.
No, but I might call your mother-in-law.
Please don’t, Dale. You’ll get me in trouble already.
Yeah, great. So yeah, so anything else that kind of came up for you that were considerations? You’ve talked about finances, you’ve talked about family, you’ve talked about you’re going to a geographic location which you’re familiar with and you know how to, but it’s not an easy place, not as easy place to be as perhaps over in the United States. Anything else that kind of comes to mind?
[28:05] Well, there’s one other thing that comes to mind and this really has to do with the big D word that nobody wants to address. Dale, I will die at some time and retirement brings up the sense that, Oh, I am moving in that direction.
I have a colleague who at 62 died and I don’t mean to dance on his grave at all.
He just knocked off one day, but, um, I am 64 moving on 65.
So I have succeeded and exceeded by three years, his lifespan.
[28:43] But more importantly, as I age, I want to think that more important than whenever that day comes for me, it’s what comes before that.
I want to live as best as possible, as actively as possible before that day comes.
As it will inevitably come to all of us with due respect to you, Dale.
Well, I agree. And for me too, some of the consideration was there’s a lot of things that I want to do, especially a lot of travel.
And I want to do that when I have the abilities that I now have to be able to do that.
And I need a sense of freedom to be able to do that.
And so being employed made it more challenging, not impossible, but made it more challenging to accomplish some of those things.
So one of the things that we know about aging is most people in the very late years of aging lose function.
We haven’t figured that part out yet. Still most people even get to that place where they don’t function so well the last weeks or months or even years of their life.
And so while I have function, I want to really use that to my fullest capability.
That’s right. And we can’t see into the future. We can’t see into the future.
[30:09] So I don’t know what else to say. Yeah. So that’s a great place for us to kind of wrap up. I really appreciate this opportunity to.
[30:22] Pause and reflect on this. I don’t know that too many people have this kind of conversation.
We just sort of celebrate the event of retirement for people. I know people are jealous when they I don’t know if you’ve already started getting that from some people, like I’m so jealous.
So we sort of celebrate that and we celebrate people’s lives after that moment, but we don’t really have this conversation about what’s your intention.
And so I really appreciate this opportunity to explore that, to deconstruct it a little bit. I appreciate your candor and honesty about what’s going on for you around this process as well. Thanks, Dale.
And we shall see. The whole point of it, from my point of view, is taking that intention and putting it into action.
Yeah, yeah. And I know you really well. And I know that, generally, your track record is pretty good in that.
So I anticipate that this will be the case. And so who knows?
I know that you and I will be communicating in the coming months and years.
Maybe we’ll go back to these microphones and see how things are going on the other side.
10 years time, I hope to be here, Dale.
Okay, awesome. Thank you again, Bill. I really appreciate it.
Thank you, it’s been a pleasure.
[31:43] Here are my takeaways from this conversation. Typically, talk about retirement usually focuses on financial readiness.
In contrast to that, we talked about what we can do to maximize the chance that this too will be a fulfilling chapter in our lives.
So along those lines, number one, be intentional. We heard Bill’s intentions about being, number one, physically active and his interest in returning to Zumba, among other things that I know that he does.
And number two is mentally active.
And we heard him talk about modeling after his mother and his uncle by going back to school, being around younger people to keep us churning, moving, and not stagnant, or engage as a participant in life.
For Bill, it is to integrate more into the fabric of a different culture and a different country.
Number two, consider doing the same work as your pre-retirement profession, just in a more limited way. In Bill’s case, he articulated that his professional identity is important, And this is a way to continue to honor that.
[32:55] Number three, related to retiring, consider the impact that this will have on those you have worked with or served and take appropriate action. For those of us who have had longitudinal relationships with patients, prepare them for your departure and as I learned, thank them for trusting and working with you all these years. Number four, regularly reflect on what brings meaning and purpose to me uniquely.
We talked about some research that indicates that those who live their meaning and purpose live long and well.
For Bill, he easily recognizes the meaning he derives from family, social interactions, and giving people a voice.
Not to be morbid in any way, but we do need to recognize and even embrace that eventually we will die.
And by so embracing this, we prompt ourselves to live well until that actually happens.
Finally, at MD Coaches, we are well aware of the adjustments that occur as one prepares to or actively retires.
It can be a challenge.
Just a reminder that coaching can be an effective way to assist you with navigating this time in life.
For more information about our coaching services, visit mymdcoaches.com.
Thank you and be well.
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