For you Billy Joel fans, today’s department is “When will you write your masterpiece?” It’s a relatively obscure song, but it’s played in my mind for years as I anticipated this day. This will be my last Dugout Dirt column, and here’s why.

Yep, long story short, I did it. This week I retired from our large private OD/MD practice after 33 ½ years, and three years of optometric practice in the U.S. Air Force. 

I had offloaded my partnership equity and slowed down a bit three years ago, as I saw this coming. Multiple reasons are involved. Mostly, it’s that time in life, with a significant case of chronic burnout, and a slight fear that I won’t be the best doc for the job at some point.    

Perhaps there are a couple of points to emphasize. 

If you’ve practiced for 35-40 years and love your patients, still bounce out of bed in the morning, and have an assistant ready with your coffee, read no further. On second thought, read this before X-ing me out:

Are you still the best doc for the job, or are you staying too long at the dance? 

As humans, we are notoriously poor at assessing our own skill sets, especially as we age.  My Dad demanded the car keys at age 90, the week after spending a month on a ventilator for cardiopulmonary failure. Others see the sometimes-not-slow decline in sharpness and currency of techniques and methods. Sooner or later, the curves of rising wisdom and decreasing relevance will criss-cross. “But but but, my patients LOVE me,” you’ll protest.  Love is all at once everything, and not what any of this is about. 

I’ve seen associates and partners, both OD and MD, who kept grinding onward and it’s not pretty in many cases.

I vowed a long time ago to never inflict that on a patient. Health care challenges have been compounded by today’s patients evolving into something that I often don’t recognize. Let’s follow a baseball analogy. Joe DiMaggio quit at a very competent age 36, inspiring Simon and Garfunkle’s song. Conversely, Willie Mays fell on his face while running to first base in the All-Star Game when he was well after age 40. An aging Mickey Mantle was struck out by Tom Seaver in another All-Star game. The Mick’s body language and overmatched swing indicated that he no longer belonged in the club. I think you get what I’m saying.

The other concern I had was personal enjoyment and satisfaction. 

About two years ago, it was almost as though someone flipped a switch. Patient scenarios I had previously enjoyed had become a chore. We joke at length on the ODs on Facebook page about “Don’t you hate it when….”  Somehow these jokes became less like humor and more like grim reality for me, as they mounted day in and day out. Maybe I hit my limit after about 200,000 patient encounters? I believe that my competence and grace held up, but when I started to wonder, I knew it was time. 

So, what’s next? I am proud and ecstatic to have accepted Novartis’ offer to work as a Medical Science Liaison in their Ophthalmology division.

Novartis has such a great group of positive and energetic people. Their current medications and the wonderful product pipeline are inspiring. I’ve always loved the science of our ocular disease processes and treatments, so this should be an excellent fit. I can’t wait to get started! Soon!

The chain of events leads me to also retire from writing Dugout Dirt. 

It’s been such a pleasure, as Alan and Marci have allowed me complete leeway in topics and slant. The new post simply has too many potential conflicts to sort out, in writing an often-clinical column. I am so grateful to have had this opportunity and grateful for your readership! If you wonder if good things must come to an end, here goes your proof.

All the best to everyone, and warm thanks for putting me up and for putting up with me!

“Do what’s good for you, or you’re not good for anybody…..”  Billy Joel