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Time For 'Dr. Next'?

Elyas Bakhtiari, for HealthLeaders Magazine, July 9, 2009
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Part of their advantage comes from training. Instead of the lecture halls and fact-based programs that Baby Boomers came up in, younger doctors increasingly learn in smaller groups with emphasis on teamwork, information processing, and problem solving, says Kirch.

"Previously, we acted as if physicians could accumulate all the knowledge they needed and carry it around with them. But the amount of relevant information for making clinical decisions now far exceeds the ability of one brain to hold it," he says. "So the current student understands that even more importantly than accumulating facts, they need to be adept at accessing and judging information in real time while doing clinical work."

And the healthcare system is slowly beginning to reflect the priorities of the new training environment. Medical homes and other pilot programs are teaming physicians together and demanding more collaboration and coordination than ever before; processes and outcomes are being tracked and used to improve quality, and even determine payment; and hospitals and physicians are being pushed and pulled away from paper records.

"If in the end we've solved the problems of our healthcare system, including quality and safety, by being more collaborative, more team based, and better at using evidence, this generation is primed," says Kirch.

The handoff
That Generation X, with all its advantages and flaws, will soon take the reins of the healthcare system is indisputable. But is it destined to be a rough transition? Is there anything hospitals and physicians can do?

"That's really the million-dollar question," says John Jeter, MD, CEO of Hays Medical Center, a 153-staffed-bed community hospital in Kansas. He accepts that some of the characteristics of Generation X physicians aren't going to change. Hospitals will have to adapt their recruitment strategies as much as possible and learn to deal with the rest.

"It's going to be more expensive to have doctors on staff than it has been in the past, that's the bottom line. We need to be prepared for that as hospital administrators . . . Instead of having four doctors to cover a practice, you may need five or four and a half," he says. "You have to meet new demands. I think you just have to live with it."

Strategically, that may mean hospitals continue to embrace some workforce trends that have already begun. Hiring more physician assistants, nurse practitioners, and other nonphysician providers can fill gaps in coverage and move healthcare toward a more team-based care environment. Generation X actually likes being employed, so that model may give hospitals an opportunity to align closely with its providers and avoid some of the pitfalls of a competitive market.

Mentoring is also important. Hospitals may need to be more conscious about mixing and matching groups so older and younger physicians are working together, says Jeter. There is a danger for conflict, but also an opportunity for learning.

"The one key thing is cultivation," says Cogley. "Research shows that these younger-generation physicians want to be mentored—not controlled, but mentored. They want to be led by example. Administratively, a lot of hospitals are adopting mentoring programs for that."

Ultimately, the best way to find out how to make the transition smooth is to ask the physicians directly. But hospital administrators, frequently Baby Boomers themselves, often have trouble communicating with Generation X, says Powell.

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