PHILADELPHIA A new generation of young physicians will redefine what it means to be a medical professionaland how to balance a successful career with a rewarding personal life.
That's a prospect that Dr. Lawrence G. Smith views with optimism. As young doctors with different values enter practice, older physicians have a chance to "build bridges" and help renew the profession, he said at the annual meeting of the American College of Physicians.
As physicians, Baby Boomersa generation of optimists and workaholics"have done nothing in medicine to improve social justice." Boomer doctors generally "value physician autonomy over quality of care," a stance that is "perniciously negative." Boomers have not fought to improve access to care or to ensure that health care resources are justly distributed, he said.
The legacy of the Baby Boomers is "the most mediocre, high-cost health care system the world's ever seen," said Dr. Smith, dean of the Hofstra University School of Medicine, Hempstead, N.Y., and chief medical officer for the North Shore-Long Island Jewish Health System, Great Neck, N.Y.
Yet Boomer doctors keep asking: "Why is the young generation so unprofessional?" As evidence of what many see as a "crisis in professionalism" and a "horrific conflict" brewing in the workplace, Dr. Smith cited data from Merritt Hawkins & Associates, a national physician search and consulting firm. In a 2007 survey of doctors aged 5065 years in various specialties, 68% of the 1,175 respondents said that newly trained physicians are less dedicated and hard working than the senior doctors were when they started out.
New doctors are starting medical school later in life, are predominantly women, are ethnically diverse, are wired into technology, andabove allare determined to "work to live," in contrast to the Boomer ethos of "living to work" that defines people through their jobs. To accommodate young physicians who value predictable workweeks and control of their lifestyle, medical practices will need to offer flexible hours, child care, a culture of quality, and a reward system that emphasizes excellence over sheer endurance, he said.
Generation X physicians (born in 19651980) have begun transforming medical practice by rejecting the Boomers' pride in long work hours, focusing instead on achieving balance. These doctors are members of a pragmatic, cynical, self-reliant generation that doesn't believe in "paying your dues," hierarchy, and micromanagement. "They will work hard when they work," but they want freedom and time, Dr. Smith said.
Members of Generation Y (born since 1981 and also known as the Millennial Generation) are just starting medical school. This was "a safe, protected, sheltered group of kids" who grew up going to "play dates" and other planned activities, and who now have "helicopter parents" eager to be involved in their college lives. They tend to be conservative, rules oriented, fond of security, and like working in teams. This optimistic, achievement-driven generation "is looking for work that has meaning," and thus may go "back to the roots of medicine," he said.
Generation X and Generation Y physicians need to be "unafraid of falling totally in love with being a doctor," Dr. Smith said. Their reluctance to be totally committed to a medical career is a reaction against the Boomer tendency to equate professional commitment with a willingness to sacrifice their personal lives.
Senior physicians must show younger colleagues that they value and expect commitment to patient care, altruism, and patient advocacy, he said, but make it clear that success won't be measured by "how many hours you work."