01/15/2012 08:39 pm ET Updated Mar 16, 2012

Good News in Retirement

A friend once said of his golden years, "The days get longer and the years get shorter." Retirement surely does bring challenges, but my sense is that the common feature among those who find retirement pleasant and fulfilling is developing interests or activities to fill time and occupy attention. These interests or activities may be related to what the retiree did previously or they may be something entirely new and different. In my own case, I guess it was somewhat of a cross between the two.

For 35 years, I was a professor in medical school, a job that involved teaching, research, patient care, and administration, in proportions that varied from time to time. It was both exciting and fulfilling as a career, and -- at least by conventional criteria -- it was also productive. Settling into retirement in the idyllic setting of the California desert near Palm Springs, I did the usual kind of things one does on leaving the ranks of the employed. I wrote a couple of books and read many more, I delved into Scottish history and published several articles on the subject, I worked at improving my tennis game (with limited success), and my wife and I traveled.

But then I ran into an organization called Volunteers in Medicine or VIM for short. A local group was opening a clinic in the area, a free clinic aimed at providing primary health care services to folks of limited financial means who lack any kind of health insurance or governmental coverage. Our area might appear at first glance to consist of affluent retirees, but beneath the glamorous surface are people at the opposite end of the economic spectrum. Unemployment is high and many of those who have jobs do not receive health benefits.

Thus it was that I found myself back in medicine, after a decade's absence. VIM provides primary care, so physicians to give this sort of service were what was needed. There was little or no need for the kind of specialty medicine that I was qualified for. Moreover, medical knowledge had undoubtedly changed in the ten or 12 years since I last practiced. All of this gave pause for thought when considering if I should join VIM. But I had always tried to maintain some degree of familiarity with the broad range of medicine, so I said I would give it a try and cover an occasional clinic. The initial experience proved satisfying beyond any expectations and I must say I am now enjoying medical practice, admittedly on a limited basis, more than ever. Why should it be even more pleasant and satisfying now that it was when I did it for a living?

One reason probably is that it represents coming full circle. I went into medicine anticipating that I would be a general practitioner in rural Iowa, and here I am, not in rural Iowa, but practicing general medicine. After a career in specialty and subspecialty practice, it's interesting and even exciting to return to my roots in medicine. It's also refreshing and satisfying to discover that practicing medicine is in some ways like riding a bicycle -- and that I can still do it. I usually schedule myself to work at the same time as a generalist volunteer, so consultation is readily available.

Secondly, VIM has given me the opportunity to do what I really like, what I went into medicine to do -- take care of patients -- without the unpleasant distractions that plague medical practice nowadays. I did not go to medical school to learn how to code diagnoses so as to increase reimbursement or how to fight with insurance companies to get them to pay for services they deny or how to order unnecessary tests in case they're needed to defend a malpractice charge. To be able to do what one likes, free of such distractions, is a thing of inestimable joy.

Finally and perhaps most importantly, I have the distinct feeling that for the patients I see at VIM, this is their only option. Without VIM and without me they simply would go without care for their illnesses, some of them serious and even life-threatening in their potential. The thought can be a little intimidating, but to be part of its solution is also immensely satisfying. Many of the folks I see have conditions like diabetes, high blood pressure, or high cholesterol, problems that can be managed quite simply and effectively in the clinic but can if untreated threaten life and limb and require in-hospital treatments that are unpleasant, extensive, and expensive.

We live in a "me" generation and a common question is "What's in it for me?" In my case, it turns out to be a whole lot.