There is a lot about young people that I don’t understand. Tattoos, body piercing, rap music and a complete lack of desire to detach from smart-phones are a few likes that make little sense to me.
But one of the new generation’s basic tenets that I find highly enviable is their desire for balance between work and life. That’s really smart, as balance makes for better everything: better marriages, better doctoring, better cycling, (and even better blogging).
In private practice, we see this phenomenon when young doctors interview for a new position. Both men and women alike ask most about the amount of night call and weekends, time off and daytime work load. Rare are the throwbacks who want to work more.
The problem with doctors working less, of course, is that our country already has a shortage of doctors, especially in primary care. This shortage further exacerbates the cost of care because it drives patients to emergency rooms, profit-driven walk-in clinics or not to the doctor at all (which means less prevention.) Almost everyone who isn’t a doctor has faced the problem of getting a timely appointment with a well-thought-of doctor. And it’s not just primary care doctors that are hard to find, specialists are in high-demand as well.
We can all agree that a solution to the doctor shortage is needed.
Weekend readers of the NY Times were treated to an interesting idea on a possible remedy for such a vexing problem. It came in the form of a distinctly un-grandmotherly Dr Karen Sibert, an anesthesiologist, who offered young people (mostly women) this gem:
“They must understand that medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve.”
With a stunningly paternalistic tone, she advocates stemming the shortage of doctors by rekindling the old ways where doctors worked all day, many nights, had few other interests and barely saw their families.
That’s a solution? Really?
In the current medical climate of hyper-regulation, burdensome bureaucracy and declining reimbursement this modus is a recipe for burnout, early retirement and even medical mistakes. A colleague of mine whose Dad was a cardiologist, liked to remind his son of this wise tale: you can angioplasty in the day, or in the night, but not day and night.
Kevin Pho, a leading voice for doctors, wrote that our “health system needs to change, and adapt to physicians who choose to place both medicine and their family on an equal pedestal.”
He’s right, and so are the younger people who refuse to inflame themselves.
In medicine, what was, rarely remains what is. And in this case, what was, clearly isn’t best.