Retirement isn’t the end of medicine, it’s a second act [PODCAST]

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Many doctors picture themselves practicing until the day they die. Andrea Hayes decided otherwise, and tells you what came next. She is a retired endocrinologist, author, and speaker. This episode is based on her article “From endocrinologist to writer: a doctor’s second act,” published on KevinMD. You will hear how 30 years in practice, 25 of them independent and five in concierge medicine, ended without a single dramatic exit. She describes the office manager who stole a quarter of a million dollars while she was grieving her father, and how that betrayal pushed her to learn the business side she had ignored. She explains why she now tells physicians to build a plan B, a plan C, and a plan D, and what she found out about publishing after traditional publishers turned her down. She also explains how living with type 1 diabetes since age 15 shaped how she connected with patients. Stay to the end for her case that it is never too late to become someone you did not expect to be.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Andrea Hayes. She’s a retired endocrinologist, author, and speaker. Today’s KevinMD article is “From endocrinologist to writer: a doctor’s second act.” Andrea, welcome to the show.

Andrea Hayes: Thank you so much, Kevin.

Kevin Pho: All right. Let’s start by briefly sharing your story, then we’ll jump right into your KevinMD article.

Andrea Hayes: OK. My first introduction to medicine was at age 15, when I developed type 1 diabetes. From then on, I had an interest in medicine. I went through all the training and started my practice at age 32.

During the 30 years I’ve been in practice, I’ve accumulated so many stories that I just kept in my head. I never had time to write. I was always seeing another patient or managing the business. So finally, in my golden years, I’ve decided to put those stories down on paper.

I think I’ve gained a lot of wisdom over the years on various things, and I also write with a lot of humor. I’ve found that humor is a way to deal with some of the tragedies and struggles that we all have in life. And medicine at its foundation really is about stories and storytelling: the stories, of course, that our patients share with us, and the stories that we physicians tell each other about all our struggles and all our adventures in our health care system.

Kevin Pho: Your KevinMD article is “From endocrinologist to writer: a doctor’s second act,” and it really chronicles your transition from physician to writer. Why did you decide to share this story with my audience? And then we’ll talk about the article itself, for those of you who get a chance to read it.

Andrea Hayes: Well, I wanted to let doctors know that there is life outside of medicine. I was immersed in it for so many years, and like many doctors, I thought, “I’ll do this until I die, and they’ll take me away in a hearse.”

I finally decided that it was time to take a step back, be a little bit introspective, and find another passion, and medicine was always my passion. I don’t feel like I’ve lost my identity as a doctor. I just feel that I’m sort of practicing it in a different way.

Kevin Pho: So tell us about the influence stories have had on your professional career.

Andrea Hayes: Well, I have so many stories. As you know, I’m a patient with chronic disease. I also developed MS and hypothyroidism in addition to diabetes, and I had two episodes where I nearly lost my life. One was from sepsis. I was on a ventilator and had a 10 percent chance of survival. The other time was after a facelift that went wrong, and again, I was on a ventilator.

When you are in those life-threatening situations, it gives you such a different perspective on what it’s like to be that vulnerable, to feel like things are going down the drain and you can’t do anything about it.

That gave me a lot to dwell on and think about, especially the first episode, because the doctor taking care of me treated me like an adversary. I was so afraid and struggling, and I didn’t note any kindness. He thought I was trying to manage my own care. I knew things were going downhill, and they did. I ended up on a ventilator on the fourth day.

But anyway, those are the types of things. My other stories include the betrayal of an office manager who stole a quarter of a million dollars from my practice. Another is that my dad died of dementia, and I watched him struggle for two years. All those things really changed my perspective and taught me a lot.

Kevin Pho: Why is it important for physicians to share these stories with the public and not keep these stories to themselves?

Andrea Hayes: Well, doctors are human too, just like our patients. We’re all really in the same boat. I just feel like we all have a lot of knowledge and stories to share, and it makes you feel not so alone in the world when my patients go, “Oh, you go through that too. You get low blood sugars too.” That was always a real bonding experience, to be able to share the same disease with my patients.

Kevin Pho: So you have retired from clinical practice, is that correct?

Andrea Hayes: Yes. I spent 25 years in my huge independent practice in Nashville, and then five years in concierge medicine in Florida.

Kevin Pho: So talk to us about that transition, because one of the things you alluded to earlier was that question of identity, right? A lot of physicians feel, as you said, that they’re going to be practicing medicine until they leave in a hearse. So they’re fearful about any type of identity outside of clinical practice, and you have made that transition very successfully. You obviously have so many stories to share. You’re an author and a speaker. So tell us about that evolution of your identity from a clinical physician to who you are now.

Andrea Hayes: OK. Medicine changed so much over the years. I started in 1997, and independent solo practitioners are pretty much out of style now. It became harder and harder to run a practice, and COVID was the final thing. We went to telemedicine in one day, and I had to keep the practice alive and profitable, keep my employees employed, and keep the patients taken care of.

So eventually, I felt like I’d had enough. Concierge medicine was appealing to me because I thought, “I’ll get paid for what I actually do, and I’m not billing the insurance company and waiting a year to get paid.”

I liked that concept, but in concierge medicine, I learned you can never escape insurance companies. Patients have insurance. You still have to do prior auths and all the necessary evils of keeping patients healthy.

So anyway, I think I made the transition pretty successfully because I didn’t lose myself. I felt like I’d done enough.

Kevin Pho: Now, was there a final straw that made you leave clinical medicine, or was it a planned glide path?

Andrea Hayes: Well, COVID really was sort of the final straw. But then there were my employees. I always loved my employees, and they’re what made me happy all day, but they started getting a bit disgruntled, and it just wasn’t fun anymore.

So it was not one moment in time when I threw my stethoscope at the wall and said, “I’m done.” It was just a gradual evolution. Also, my dad had built me an office building, and that was my nest egg, and I decided it was time to sell and move on.

Kevin Pho: So tell us what your life is like now as a writer and a speaker. How do you distill all the stories you’ve accumulated over the decades into something publishable?

Andrea Hayes: Well, I have two memoirs that are going to be coming out soon, within the next year. The first one I wrote is about everything: the emotional ups and downs, patients, betrayal, blah, blah, everything. The second one is called Peach Cobbler Is Not a Fruit, and it’s a bunch of funny stories about what patients say, what they rationalize, and what they do. It’s based on humor, but there are a lot of other things in between.

Kevin Pho: Now, do you have a whole process for putting the stories from all your experiences onto the page? Do you have any formal training in writing? What’s your process like?

Andrea Hayes: Well, I’ve taken a few courses, but I have no real formal training in writing. I basically just pour myself onto the page. I have an editor, and I have a publishing company called She Writes Press. They’ve helped me a lot along the way, but I’m learning so much about things like book covers and how to get your book placed in the right place on Amazon or in bookstores. So it’s a learning process. I’m really enjoying it. It’s a whole new thing for me.

Kevin Pho: Now, who is the intended audience you want to read your books, and what are some of the goals you want them to achieve after reading your memoir or your other book?

Andrea Hayes: Well, really anybody who has a body will enjoy reading the books, because they’re about the absurdities of living in our human flesh. But particularly, I think, doctors and people in medicine, patients who live with some of the diseases that I have or have made it through a severe illness, and people who have family members who have been sick.

I think everybody has, or will have to have, some relationship to medicine. The older we are, the more things might happen. So it’s a lot of human stories that anybody could read, but especially medical people.

Kevin Pho: Now, as you know, practicing medicine is becoming increasingly difficult, and what you’re describing is very similar to what a lot of physicians are facing today, especially with all the bureaucracy, the insurance companies, and of course, the impact of artificial intelligence. Tell us some key pieces of advice you could share with these physicians, because I talk with them every day on this podcast about how difficult it is for them, and you’ve experienced decades of practice. What are some key pieces of advice you could share with our physicians practicing today?

Andrea Hayes: Well, I would say you’ve got to change with the times. We’re not going to be able to change this system overnight. You have to be adaptive and innovative and change so that you don’t lose yourself. You can’t practice medicine like anybody did 25 years ago. It’s a whole new ball game, so learn how to still enjoy it. Hopefully, it’s somewhat profitable, but find other avenues for yourself. There’s got to be a plan B, a plan C, a plan D, and you have to just keep on evolving with our technology.

I remember years ago when electronic medical records came out, and older doctors were like, “I’m never doing that. I’m going to handwrite all my notes forever.” You can’t use that mentality. You’ve got to grow with the system that we have.

Kevin Pho: So what’s an example or a story from your own experience where you’ve changed or evolved over time? Would it be that transition to concierge medicine, or would it be something similar or different from that?

Andrea Hayes: Well, I feel like I’ve changed a million times. I feel like I’ve lived a thousand lives. My constant has been that I’ve got to change with my circumstances.

One example is that before the office manager got away with all the money, I had no interest in the business of medicine. As long as the lights were on, I was like, “Yeah, cool. You guys do that. I’ll do my thing with medicine and the patients and the staff.” When I discovered what happened, I was so mad and angry that I wanted to kill the guy.

Kevin Pho: Tell us more about that story. You said that office manager stole a quarter of a million dollars from your practice. So tell us about that story. What happened?

Andrea Hayes: Well, my dad, who was a retired engineer, was my office manager. He built the building. He helped me do all the administrative stuff that I didn’t want to do, and then he developed dementia. As this guy saw my dad losing his mind, he jumped right in and became my life advisor, like my dad had been, and I was way too trusting. He knew all my bank accounts, all my passwords, everything about the business, and everything about my finances. I was just very naive and way too trusting.

But after that happened, I poured myself into learning the finances and running the business. Thank God for my nurse practitioners. I had three wonderful ones who helped take on a lot of the patient care while I spent half my time sifting through bank statements and learning how to do QuickBooks, payroll, 401(k)s, health insurance, and all that stuff. So that was a dramatic way I became somebody totally different than I was before.

Kevin Pho: How did you find the resilience to bounce back from that? That sounds like a pretty huge blow, especially running a private practice and having someone you trusted steal that money from you.

Andrea Hayes: Well, part of the reason he got away with it was that I was grieving about my dad every day. I was crying between patients. I had a lump in my throat all the time, and I was just oblivious to other things that were going on around me.

So when I finally discovered it, I had all this emotion in me about my dad, but somehow I ended up channeling that into saying, “This guy is not going to steal my practice. My dad and I built this. I’m not going to let him get away with it.” So instead of taking time to grieve, I had such a mission. I had to stick my finger in the dike before the flood came in, because there were still bank accounts that he had access to, and there was a lot to clean up. He hadn’t paid our property taxes in years. So I had all of that to clean up and figure out, and I didn’t have time to sit around and grieve any longer.

Kevin Pho: You mentioned earlier the word profitability, and it sounds like you’ve obviously learned the business of medicine. For physicians today who may be stuck in a prior mindset, where all they wanted or had the interest to focus on was the clinical side, tell us how important learning the economics and business of medicine is today.

Andrea Hayes: Oh, it’s vital, and the thing is that we don’t usually have any training in this. I think doctors are usually pretty poor businessmen and women. But when you’re talking about your livelihood and your practice, whether it’s solo, within a group, or employment, you have to understand all of that. You have to just make yourself understand it, because the biggest problem comes when you put it out of your mind and say, “Somebody else will handle that.” The bottom line that I found is that I couldn’t trust anybody but myself, aside from my dad. That was the brutal wake-up call: I needed to understand all of that.

Kevin Pho: Now, what about physicians who want to transition more into writing? Because like you, I’m sure so many doctors have so many stories to share and tell. Any advice for them if they eventually want to publish some of their stories?

Andrea Hayes: Yes. It is really difficult to do traditional publishing. I wrote many inquiries and got no response or immediate rejections. I just happened to find this publishing company that is a hybrid, which means that the writer puts forth a good bit of money, and then you get much more of the proceeds, but they help you all along the way.

I would encourage doctors to consider self-publishing or other nontraditional methods of publishing. If you feel that it’s your passion and you have a lot of wisdom or stories or humor to share, then do it. But don’t try to go through regular publishing companies if you don’t have any experience in that.

Kevin Pho: How did you keep track of all your stories during the past decades? Did you have some type of journal? Did you have some way to record them as they were happening?

Andrea Hayes: Oh, no. They just remained lodged in my brain. I didn’t really start writing them down until maybe the last four years.

Kevin Pho: We’re talking to Andrea Hayes. She’s a retired endocrinologist, author, and speaker. Today’s KevinMD article is “From endocrinologist to writer: a doctor’s second act.” Andrea, let’s end with some of your take-home messages that you want to leave with the KevinMD audience.

Andrea Hayes: Oh, I would like to say that it’s never too late to transform yourself and to become somebody you never thought you’d be, whether that’s leaving medicine and doing something completely different or staying in medicine in some way.

I would just like to give encouragement to those doctors who feel like it’s time to retire or do something different, and to let them know that the sky’s the limit. After retirement, you have time to really focus on these other things, and it can be very joyful and uplifting.

Kevin Pho: Andrea, thank you so much for sharing your story, time, and insight, and thanks again for coming on the show.

Andrea Hayes: Thank you for having me, Kevin.

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