Reflections on Going Into "Private Practice"

This was written in July 1992 on a particularly sweet and bright summer day in Pennsylvania. I was spending the summer "at home" before returning to Clemson for my last semester of teaching. It was the first summer since I was fifteen that I had not been working in a job and also the first time in more than 25 years that I had had more than two consecutive weeks off work, without being ill or laid off.

I wrote this piece for myself but after it was finished, I sent it to Elaine Duncan, Editor of Biomaterials Forum, who subsequently published it (Vol. 14(4):10, 1992). I enjoyed seeing it in print but thought little of it at the time. Since then, I have received many kind comments about it, perhaps more than about anything else I have ever published! Apparently this short piece struck a sympathetic chord with many of my friends and colleagues.

In the middle of May this year my wife and I moved from South Carolina to Pennsylvania as a first step in a transition from full time academic life to semi-retirement, while continuing several industrial consultancies and part-time university affiliations. As of June 1, I have been working from home, essentially, as a clinician would say, in "private practice." I know that many members of the Society¹ are in similar situations but there has been little public discussion about the professional and personal implications of such a life setting.

First to the personal: We each try to make our home as pleasant a place to live as possible, but then leave it, at least five days a week, for nine or ten hours a day (or longer, depending on commutation times) for far less satisfactory surroundings. This summer, for the first time in 38 years, I have been wakened by the dawn rather than the alarm clock. I now have a twenty-five foot (!) commute and can see the mail when it arrives, wander out into the garden (with or without dog, depending upon her state of wakefulness) and prepare what I want to eat for lunch rather than settle for what is available from a cafeteria, canteen etc. It is also very pleasant to see my life partner at times other than in the morning when we are both half asleep or the evening when we are both tired and cranky. A friend of mine² remarked that retirement (rather than full-time work) is the natural human condition - I tend to agree, even after my brief experience.

But the professional aspects are perhaps more important. Private practice brings a degree of autonomy which exceeds even that available in the university. I must weigh and balance the value of each task from a different perspective. I still review (referee) manuscripts, since this is part of "PhD-Man's (and -Woman's) burden" but the task seems much more important now rather than merely an escape from other, less desirable jobs. I am forced to think about what I really want to be doing now and five years from now. These are questions that over the years I have routinely asked my students in an effort to help them order their careers but which I have not seriously reflected on myself in a long time.

Another aspect: Yesterday I was startled when a secretary at the work place of one of my industrial clients asked which institution I was at. While I have five academic affiliations, I am now, as it were, at no institution but, like a released prisoner, have the freedom of the commons. Her reaction to my explanation was quite odd: she had difficulty accepting that an adult person was not at (or of or in) an institution.

Perhaps we should all consider escaping from our institutions. While early retirement/private practice is not a viable option for all, working as an independent contractor rather than as an employee is for many. There are pluses as well as minuses: the all enclosing institution is a pseudoparent which provides identity, group benefits and an extended family. However, if more scientists and engineers chose to be independent, in this sense, I believe that the professional status of our respective disciplines would rise and we would enjoy many of the benefits which medical professionals, independents all, experience.

1 Biomaterials Forum is the newsletter of the Society for Biomaterials

2 Emanuel (Manny) Horowitz.