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Generations Apart

Rick Johnson, for HealthLeaders News, December 6, 2007
I just knew I was asking for it when I filed a column about Gen X and Y docs. Last week, I put forth the perception of many administrators and physician leaders I know that this younger crop of clinicians is less engaged in their careers than previous generations. Some readers took me to task for perpetuating such broad, and in their opinion unfair, stereotypes.

But it is not my job to shrink from such sensitive topics. I'd much rather share with you some of the thoughts and stories readers have been kind enough to give me.

Since this is such a delicate subject, most were not willing to go on record with their statements. I'll do my best in this space to synthesize their views. Perhaps the frustrations communicated below can initiate a dialog that leads to empathy and understanding between the medical community's generations.

A generation of moderation
A reader identified herself as a Gen Xer four years out of residency. She attributes her generation's desire for work-life balance to seeing too many boomers with excessive, self-destructive work habits. She points out that younger professionals also are skeptical of promises from institutions because they often go unfulfilled. At the same time, this reader says that she and many of her contemporaries have simply learned to be more efficient than older doctors. In her case, she notes that she is an ER medical director, holds leadership positions, and has a multi-state commute--yet she still makes time to enjoy her friends and family.

Just a job
A 50-year-old hospital chief of staff wrote me to say he agrees with the comments from my last column. In fact, he has seen firsthand a lack of professional engagement from Gen X and Y doctors. "When they interview, they want to know about salary and time off more than anything else," he said in an e-mail to me. "It's disheartening to see."

An evolving industry
And perhaps the real change is not with the newer physicians as much as it is within other facets of the industry, another reader says. He suggests that for the boomer generation, a social contract called on them to put in the labor of building a private practice, and in the end they would own businesses that held great value. Today the ROI just isn't there. Reimbursement shrunk and medical institutions grew. Since their time and efforts are not building a practice that they have an ownership stake in, doctors instead look for direct compensation for their efforts.

Consider the future
In the end, a boomer CMO says the productivity lost when older doctors retire will be dramatic for the industry overall and perhaps catastrophic for primary care. In addition, his hospital's chief quality officer is worried about the lack of commitment not only from newer physicians, but also from nurses.

These anecdotes point to a very real gap between the age groups. In fact, an October 2007 survey found that older physicians--ages 50 to 65--are unimpressed by the work ethic of today's younger doctors. Sixty-eight percent of respondents to the Merritt Hawkins & Associates questionnaire indicated that physicians coming out of training today are less dedicated and hard working than physicians who came out of training 20 to 30 years ago.

I'm not done covering this touchy topic--in fact, I suspect we've only scratched the surface. So if you have a related story to share, feel free to contact me.


Rick Johnson is a senior editor with HealthLeaders Media. He can be reached at rjohnson@healthleadersmedia.com.

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