As I approach the end of my 25-plus years of work with family medicine, I have been reflecting on endings and the process of saying goodbye. Using the term goodbye might be a misnomer. I have witnessed some rather bad goodbyes. But a “good” goodbye is important, particularly after we have invested so much of our lives, energies, and self in a place or a relationship.

Endings are as much a part of life as beginnings. Yet at these critical transition points, life can get messy and confusing. Just as patient care can go awry during transitions, so too can our relationships and other aspects of our lives.

Endings need to be handled with some care, so I'd like to suggest six ways to say goodbye well.

1. Prepare emotionally. Before you leave, give some attention not only to financial and practical matters, such as packing up your things, but also to the emotional aspects of saying goodbye. Disinvesting from a place or a person can cause emotional snags and pains — even gaping wounds if not handled well. To lessen the pain, do some emotional prep work by having proper discussions, expressing appreciation, and clearing the air.

2. Tie up loose ends as best as you can. This includes bringing your duties to completion, teaching others what they need to know for a smooth transition, and leaving your team in as good a position as you can. Don't forget how difficult a transition in care can be for your patients — not only because of their health needs but also because of their need for support and trust. Consider any bridges you can build or introductions you can make to help your patients move forward without you.

3. Let go of regrets. I have counseled many patients who live on past regrets, which is a poor diet. Although there may be negative aspects to why you are leaving, it is best to avoid focusing on these issues unless they propel you to a better place. Instead of dwelling on regrets, celebrate what you have been given and what you have given.

4. Don't wait too long. If your goodbye is too late in the sense that it is abrupt or sudden, those around you may not be able to absorb or process it in a healthy manner. If your goodbye is too late in the sense that you should have left long ago, then that too can be unhealthy. Holding on and being fearful of change can cause us to wait beyond the best time to leave.

5. Don't overdo it. We have all probably known people whose goodbyes have been too dramatic because they could not let go. A goodbye necessitates a conclusion, a separation, or some movement to another place. Over-complicating it can make others uncomfortable. Keep it short and sweet.

6. Be realistic about the future. It is easy to idealize a new move, retirement, or life change. We often need some positive thinking to help us make the change, but we should guard against being unrealistic. Author and family researcher Daniel B. Wile, PhD, has said that choosing to be in a relationship means “choosing a particular set of unsolvable problems” (http://danwile.com/my-quotes/). In other words, there is no perfect relationship — or job, location, or time in life. All have their challenges. Anticipating the good while being realistic about the future will save us from a grand disappointment.

“Goodbye” — it can be a good word as well as a good and healthy process. Embrace it, and make sure you do it well.