Retirement as a Source for Health Care Leadership

There’s a lot of gnashing of teeth out there about the erosion of 401k nest eggs into more modest “201k” sized savings. On this backdrop, in a piece published in the online edition on June 8, Business Week’s Stacy Perman provides some provocative data and vignettes on the rise of entrepreneurship in the “over 50’s and 60’s.” Seniors as Entrepreneurs: Their Time Has Come makes me wonder about how this benefit healthcare leadership picture.

The Leadership Squeeze

AARP and others have documented a trend of rising self-employment among older Americans. According to Perman:

“…experts believe the stock market’s recent brutalization of retirement accounts will prod additional older Americans to start their own businesses. A combination of economic volatility as well as the growing number of baby boomers with time, energy, and money on their hands has redefined the starting age for new startups and has led to a surge in senior citizen entrepreneurs.”

Is there any reason to believe that physicians and healthcare executives are exceptions to this trend? While a minority of “high rollers” might do just fine with 40% less retirement principal, many retired or nearly retired – but highly experienced – docs and execs are probably not all that comfortable with the prospect of the future income stream available from the “201k.”

At the same time, the following conditions converge (1) natural pressures on near-retirees to step down in favor of the next generation; (2) increasing opportunities for entrepreneurship and creativity within new and existing health care organizations; and (3) insufficient seasoned healthcare leaders to go around. In addition, if younger professionals are not encouraged to advance in their careers and rise into mid and high-level leadership positions, the resulting squeeze could lead to short-term friction and long-term distortion of healthcare staffing and leadership dynamics.

Post Career Docs and Hospital Execs as a Leadership Pool?

We used to tout the importance of capturing the value of retirees and made much of encouraging them to volunteer their time for good causes. In healthcare this often meant Board membership, teaching, or fundraising. I wonder if there’s a more intentional and strategic use for this generation. Perman notes the potential:

“A combination of economic volatility as well as the growing number of baby boomers with time, energy, and money on their hands has redefined the starting age for new startups and has led to a surge in senior citizen entrepreneurs. This is a category that is only recently being studied.”

She refers to classical entrepreneurs – self-starters who choose to begin new ventures with money to invest. This minority of individuals puts capital at risk seeking either independence in business development or high financial returns on funds they can afford to put at risk. But that’s not for everyone, and especially not for “201k-ers.”

But couldn’t we intentionally encourage the larger pool of more risk averse but highly energetic and experienced spirits to step out of hierarchical line leadership positions with waiting lines below them and into leadership for newer initiatives and structures (related to medical homes, or accountable care organizations) collaborative ventures between physicians and hospitals (joint operating councils, cross-functional service lines), or leadership mentoring roles?

More Experience, Less Filling?

These new and complex activities require creativity, experience, a degree of gravitas (which usually means grey hair), and the ability to focus on doing things differently. They would benefit from leadership with a low level of political self-interest and a high community benefit perspective. They may ultimately be essential to health system success and yet may or may not show the big financial returns (in the short run) that justify or attract high priced leadership.

Enter recent or impending retirees who have skill set, demand stimulation, may be interested and motivated to attack interesting challenges they couldn’t focus on while having stressful “day leadership” jobs, and who – as retired from active practice or hospital leadership – could be one step removed from direct self interest, and whose financial requirements may consist of “filling gaps” rather than creating de novo wealth.

Sounds to me like a promising low-calorie high energy tonic.