After four decades in medicine, I retired from the active practice of primary care 15 months ago.  I still get asked at least once a day: “Well, how’s retirement treating you?” My usual reply is that it is a learning process. A more accurate response would be that it is like playing Tetris, but with pieces that change shape and rotate unpredictably as they fall.

(For those not of a certain age, here is Tetris:

This is a repost of something I wrote in 2012 about how I discovered that doing collaborative officie visit notes with patients transformed the process for both the patient and myself.

Nearly a year ago I embarked on an adventure that has been changing how I practice medicine. It is also changing how medicine feels. 

This imaginary letter, penned after attending a Quality Initiative meeting, is fictional today, but I suspect something like it will appear in the near future and be sadly common within five years. I hope I have retired by that time, because it would be truly shameful to actually sign and send such a letter.

Dear (computer generated patient name),

I am writing to express my deepest regret that I can no longer serve as your PCP.  I will continue to provide you with all appropriate care during the next sixty days while you arrange an alternative provider.