Dr John M

cardiac electrophysiologist, cyclist, learner

  • Home
  • About
    • About Me
    • About the Blog
      • General Cardiology and Internal Medicine
    • Six Reasons why I Blog
    • What’s Electrophysiology?
    • ICD/Pacemaker
    • Electrophysiology Column / Medscape
    • Contact
  • Afib
    • AFib
    • AF in Athletes
    • The best tool to treat AF
    • Know your CHADS-VASC Score
    • 3 non-warfarin anticoagulants
    • AF ablation
      • 13 things to know about AF
      • Atrial Fib Ablation -2012 Update
      • Gender-Spec results of AF ablation
    • Female gender and stroke risk in AF
    • My AF Story
  • Heart Healthy
    • Heart Disease (by DrJohnM)
    • Healthy Living
    • Exercise
    • Nutrition
    • inflammation
  • Policy
    • Policy
    • Health Care
    • Health Care Reform
  • Doctoring
    • Doctoring
    • Knowledge
    • Reflection
    • General Medicine
      • Does your cholesterol level matter?
    • General Cardiolgy – Medicine
      • What is a normal heart rate?
      • Cardiology/Internal Med
      • General Cardiology
      • Athletic heart
        • The ECG of an athlete
      • General Medicine
      • Stroke
      • Statins
  • Cycling
    • DrJohnM on Cycling
    • How I became a bike racer
    • My top 12 Likes on Cycling
    • Cyclocross
      • A CX-Primer
    • Fitness
    • Athletic heart
    • The Mysterious Athletic Heart

Work-life balance in Medicine–Maybe the young are on to something?

November 7, 2011 By Dr John

I read an interesting story about young doctors today.

American Medical News reported that the changing desires of resident doctors poses recruiting challenges for practices. It’s an eye-opener–a look into the future of healthcare.

It seems young docs want unusual things from their career in Medicine.

The new generation of doctors seek employment, not partnership, a guaranteed salary with productivity and mostly, they want more free time. With admirable brashness they cite the ideal quality of life would be a four-day workweek with no call. Almost half of surveyed residents in 2011 ranked free time as the most important feature of their new job. Two thirds said lifestyle was a top priority.

This stuff makes me grin. It’s beautiful really–as are most things about twenty-somethings.

I can’t tell what intrigues me most: the audacity of the young, or the rancorous response of my generation.

You might assume I am going to take the typical old-doc view. It goes something like this:

As a medical student and resident, I stayed late to see cases. I snuck out of the call room on Internal Medicine rotations to follow the cardiology fellow run around putting Swan-Ganz catheters in heart attack patients (that’s all we could do then). I authored–in pen–my own surgery textbook by re-writing what was already published in textbooks. (Remember, ‘app’ wasn’t a word in the 1990s.)

Then, when I joined a practice, I worked 80 hours per week, took call every third night and ablated all day and most of the night. I didn’t stop counting pacemaker implants until 5000. After finishing in the EP lab at six, there would be 5 more consults to see. Dinner was inhaled right before bedtime.

This formula worked for me–and my colleagues. We are good doctors. Call this the good-doctor formula.

These lazy newbies just don’t want to pay their dues. They won’t be as good as we are. Medicine requires commitment and dedication. Doctors can’t be good at anything else because learning medicine is all consuming—even with iStuff. Forget being a little league coach, reading a good novel or surely racing a bike.

But…Wait a minute.

Maybe, just maybe, the young people are on to something. Do they see reality? For what enticed my generation—handsomely rewarded productivity—is gone. (Or…could they really believe technology might shorten the time it takes to learn new things?)

Isn’t it obvious that young docs are validating one of the tenets of many a medical blogger: that an unintended consequence of declining reimbursement and increasing regulation is the dis-incentive for young doctors to inflame themselves? It’s simply not worth it. Sure, they still see doctoring as noble, but at the going rate, they aren’t willing to give themselves atrial fibrillation over their job.

So they boldly and without apology seek work-life balance. Maybe it’s not that they are lazy and young. Perhaps it is because they are prescient and young.

What’s not settled is whether this is bad or good for patients?

On the one hand, we (patients) are going to have to adjust to less access. Hardest hit will be rural areas and poor neighborhoods. A negative.

But on the other hand, doctors infused with balance, rest and less incentive to chase RVUs might not be so bad. Sure, there will be more wait; but that leaves more time for natural healing to occur. (Disclosure: I am a minimalist. Almost half the time, AF stops with no treatment!)

And consider this confession of a proceduralist: (shhh) my best work happens during regular working hours after a good night of rest.

***

What will happen as the new generation of doctors displace us ‘olders’ remains to be seen.

It’s hard to bet against balance, adequate rest and young people.

And remember, optimism is clearly heart-healthier than pessimism.

JMM

h/t to the SketicalScalpel–whose post got me thinking about how intriguing young people are.

  • Email
  • LinkedIn
  • Facebook
  • Twitter
  • More
  • Reddit

Related posts:

  1. Friday Reflections: Looking back on life and teaching the young
  2. More inflammation will not solve the doctor shortage
  3. Screening seemingly healthy young athletes?
  4. Balance in life and medicine is often elusive…

Filed Under: Doctoring, Health Care Reform, Healthy Living, Knowledge

John Mandrola, MD

Welcome, Enjoy, Interact. john-mandrola I am a cardiac electrophysiologist practicing in Louisville KY. I am also a husband to a palliative care doctor, a father, a bike racer, and a regular columnist at theHeart.org | Medscape

My First Book is Now Available…

Email Newsletter

Search the Site

Categories

Find me on theheart.org | Medscape Cardiology

  • Electrophysiology commentary on Medscape/Cardiology

Mandrola on Medscape

  • My Medscape column on general medical matters

For patients...Educational posts

  • 13 things to know about Atrial Fibrillation — 2014
  • A new cure of AF
  • Adding a new verb to doctoring: To deprescribe is to do a lot
  • AF ablation — 2015 A Cautionary Note
  • AF Ablation in 2012–An easier journey?
  • Atrial Flutter — 15 facts you may want to know.
  • Benign PVCs: A heart rhythm doctor’s approach.
  • Caution with early Cardioversion
  • Decisions of 2 low-risk cases of PAF
  • Defining success in AF ablation in 2014
  • Four commonly asked questions on AF ablation
  • Inflammation and AF — Get off the gas
  • Ten things to expect after AF ablation
  • The medical decsion as a gamble
  • The most important verb in our health crisis
  • Wellness Requires Ownership

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.