Longwoods Online

Longwoods Online March 2013

A Balanced Scorecard for Your Third Act

Nan Brooks, Colleen Drain and Frank Markel

All the World's a Stage Monologue

All the world's a stage,
And all the men and women merely players:
They have their exits and their entrances;
And one man in his time plays many parts,
His acts being seven ages. At first, the infant,
Mewling and puking in the nurse's arms.
And then the whining school-boy, with his satchel
And shining morning face, creeping like snail
Unwillingly to school. And then the lover,
Sighing like furnace, with a woeful ballad
Made to his mistress' eyebrow. Then a soldier,
Full of strange oaths and bearded like the pard,
Jealous in honour, sudden and quick in quarrel,
Seeking the bubble reputation
Even in the cannon's mouth. And then the justice,
In fair round belly with good capon lined,
With eyes severe and beard of formal cut,
Full of wise saws and modern instances;
And so he plays his part. The sixth age shifts
Into the lean and slipper'd pantaloon,
With spectacles on nose and pouch on side,
His youthful hose, well saved, a world too wide
For his shrunk shank; and his big manly voice,
Turning again toward childish treble, pipes
And whistles in his sound. Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion,
Sans teeth, sans eyes, sans taste, sans everything.

– As You Like It, Act II, Scene VII

Shakespeare reminds us of the inevitable transitions of life. For those of us in the baby boomer generation, Shakespeare’s sixth, if not seventh, stage is now upon us. In particular, as we struggle with the possibility, or reality, of life without work, we face a new challenge.

As always, quality improvement is there to lead the way. Remember reading Stephen Covey[i] back in 1989? Remember the Balanced Scorecard approach from Kaplan and Norton [ii], popularized in Ontario in Hospital Report? Well, those same ideas can play a role as you consider retirement.

Indeed, Stephen Covey advised us to set goals for ourselves in a variety of domains, including our personal life, family, friends and work. He suggested planning our week's activities in terms of what we intend to do to achieve those goals.

Kaplan and Norton told us to think of the accomplishments of the hospital in terms of four domains: the strategic, the financial, our core business and our customers' perspective. Hospital Report defined those for us as:

  1. Strategic
  2. Financial
  3. Quality
  4. Patient Satisfaction

Some of us have tried to live our lives by this advice, in the context of maintaining an active professional life. We hired personal trainers to be sure we were fit. We scheduled time for our infant children’s appointments with the paediatrician; we made a luncheon date during the week with our spouse; and, oh yes, we made time to read Longwoods' Health Quarterly and attend Breakfast with the Chiefs.

Now that our careers are winding down, how should we modify this approach to suit our new situation?

The Acts of Life

F. Scott Fitzgerald, author of The Great Gatsby, is famous for having said there is no second act in American life. We would suggest that for most of us, our life can be thought of as a play in three acts. The first act constitutes our youth, a time of schooling and preparation. As whining schoolboys (or girls; Shakespeare wasn't known for being gender neutral), we were asked, “What do you want to be when you grow up?” The choices were broad. Should I become an astronaut? A teacher? A nurse? A doctor? Many hours were spent discussing the options and potential with parents, teachers, friends and other advisers. Once a direction was determined, a specific course of study was undertaken. Over a number of years, training and expertise were acquired so that we could "become" something.

Our second act is that of our professional lives. While few of us became soldiers or judges as Shakespeare suggested, our careers in healthcare have nevertheless been filled with intellectual stimulation, ego and competition. As healthcare professionals, we began to define ourselves by our impact on the health either of individuals or of the system; by our job title; by ego; by functions performed; or by committees contributed to. There was a lot of external validation (or not). We have had “career paths.” We planned for advancement. There were skills we needed to acquire to be promoted, and remunerationlists to check to determine our relative worth. There were 360-degree reviews and other performance assessments to guide us on how to enhance and advance our career.

Few people spend any time at this stage thinking about or planning for act three, life’s retirement years. In fact, many people who excel in the work setting fail miserably when their professional careers end.How many people do you know who “retired” and then “unretired” within a few months? These people likely did not prepare adequately for this stage of life. Although many dream about retirement, even count down the weeks or days until the glorious date, few of us prepare for it.

Act Three: The Age of Retirement

There is a general belief that retirement will just happen; we will be happy, and no preparation is required. After all, how much preparation do you need to not do something (i.e., work)? The same people who are mentoring younger professionals on how to be successful in their career are ignoring their own fast-approaching retirement age, what we call act three.

There are two options for act three: it can be short and you can die quickly (whether that death is physical or mental), or you can plan for it and have a long, productive, fulfilling life. 

So, what skills do we need for retirement? How do we measure success? How is retiring different from our “career stage” of life? We would like to suggest the following framework:

Act three can be a time to develop the other aspects of your personality and life that you haven’t had time to develop during your career. Those of you reading this article have almost certainly been relatively successful in your career. You have had structure and timetables for the past 30-odd years. You have a strong ego, good intelligence and awareness of political processes. These aspects of your being have had a lot of focus. Let act three focus on other aspects of your being. There are four aspects of your being to think about and plan for developing:

  1. Physicality: In order to have a long, healthy retirement, you will need some physical activity to keep you active. Planning for act three should include three or four options with regard to physical activity that you either want to perform more of, or wish to try for the first time. Perhaps you haven’t played tennis as much as you would have liked; you’ve always considered golf a game for older people (guess what! you're there); you want to ski more. Whatever, look into lessons, or arrange for memberships to ensure that you have adequate physical activity and, equally important, are continuing to learn.
  2. Creativity/Soul: Being a healthcare professional hasn’t allowed you many hours to spend on creativity or investigating matters of the spirit. Developing this "softer" side of your self-awareness can balance out the ego and intellect that you have focused on for the past 30 years. This investigation can include self-help books, new religious ideas or learning how to do pottery, weaving or computer design. Look at your life: what interests you now? Colours and textures? Do you notice what colours people are wearing? When you are at a dinner party, what topic gets you smiling and has you leaning forward in your chair? Is it new wines? Cooking? Coffee grinds? Whatever it is, develop some hobbies and new interests. Plan now for what you hope to start in the first phase of your retirement. Sign up for introductory courses, or at least investigate them.
  3. Philanthropy: After 30 years in healthcare, you may feel a need to contribute back to society. You may want to continue sitting on healthcare boards; to teach adults to read; to work with refugees; to help with fundraisers for battered women's homes; to assist children at your local school. Where is the greatest need that you think you might help to fill? What gap or unmet need makes you sad? Whom would you like to help? Start investigating these opportunities now.
  4. Intellect: Studies have shown that keeping the intellect sharp increases longevity. Lifelong learning doesn’t stop with retirement. Learning in the next phase of your life doesn’t have to follow the same direction of your current expertise. Use this next phase as an opportunity to balance your life and experience. Diversify! Is there a language that you have wanted to learn? A religion to investigate? Wine regions to explore? When you are chatting socially, what interests keep your attention? What discussions with yourself do you have when you are falling asleep?

Thinking about your act three in terms of the Balanced Scorecard can offer you a framework that helps you plan for and balance the next phase of your life. The number one rule, though, is: enjoy, play and have fun – you’ve earned it!


[i] Covey, S. R. (2004). The 7 habits of highly effective people: Restoring the character ethic. New York: Free Press.

[ii] Kaplan R S and Norton D P (1992) "The Balanced Scorecard: measures that drive performance", Harvard Business ReviewJan – Feb pp. 71–80 


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