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How to Close the Physician Age Gap

By Anna Webster, for HealthLeaders Media  
   February 04, 2011

Managing multiple generations of physicians at your practice is no easy task. Many older physicians already have retirement in their sights and some are resistant to adopting new technologies or changing the way they have practiced medicine for years. At the same time, many younger physicians are looking for tech-savvy practices and demanding a schedule that offers more work-life balance, which often means a specialty practice, not primary care. Here are strategies that you can use to manage the differing priorities of physicians, while fostering better collaboration.

Appealing to younger physicians

More and more physicians fresh out of medical school are choosing a specialty, such as cardiology or radiology, rather than primary care, because the compensation is better and often there is a narrower range of health issues that they will need to address.

For example, the average salary for radiologists for 2009-2010 was $417,000 compared to the average family practice salary of $175,000, according to a 2010 Merritt Hawkins survey. There is also a preconceived notion that the primary care field has limited flexibility in scheduling and laborious hours. So it is no surprise that younger physicians looking for a better work-life balance are turning to specialty practices that are more likely to have set office hours.

There are steps, however, that practices can take—primary care included—that will not only appeal to younger physicians, but to some older doctors, as well. Walt West, founder of the Brentwood, TN-based consultancy, Practice Management Academy, suggests adopting the following:

  • Advanced technology. Young physicians often train in facilities with the latest and greatest technologies and they seek out practices using the types of technologies they’ve trained on, such as electronic health record systems (EHR), says West. “If practices don’t have that, they won’t be attractive.”

  • Flexible scheduling. Practice managers have to change their mindset and offer more flexible scheduling, says West. Granted, offering flexible scheduling can create additional challenges for practice managers. But incorporating flexible and part-time work arrangements into a practice will appeal not only to younger docs—both male and female—but also to older physicians who may be  scaling back their practice in preparation for retirement.

On the other end of the age spectrum, many baby boomer physicians are opting to retire or limit the number of new Medicare patients they treat in the face of potential Medicare payment cuts. In a 2010 online survey of American Academy of Family Physicians members who have an ownership stake in their medical practices:

  • 62% of family physicians said they may be forced to stop accepting new Medicare patients.
  • 73% said they would have to limit the number of Medicare appointments because of the payment cuts.

Given the expected influx of 40–50 million previously uninsured patients into the healthcare system over the next 10 years as a result of healthcare reform, combined with the projected physician shortfall of as many as 150,000 doctors, according to the Association of American Medical Colleges, it is imperative that physician practices find ways to convince older physicians to keep practicing medicine.

Older physicians who remain successful in their practices are ones who choose to adapt and change with the times, says Frank Veith, MD, professor of surgery at New York University Medical Center and Cleveland Clinic.

“[Physicians] are forced out of a job if they don’t adapt to medical changes or they head into retirement,” he says. “We’re left with only the older physicians who are flexible enough to handle emerging changes in the industry.”

He suggests that older physicians should know their limits both physically and mentally. Though he no longer trusts himself to perform 12-hour surgeries, Veith keeps his head in the game by attending conferences and performing shorter procedures.

"[For] surgery you need good vision and stamina and I was lucky because I still have [them]," he says. He also suggests that they be open to learning techniques from younger physicians.

Here are three examples of how to help older physicians adapt to new technology and foster collaboration among physicians of all ages.

1. Establish social media guidelines for your practice.

Even though there are Medicare incentives for EHRs, adoption is not mandatory. The same goes for social media. Veith, 78, admits that he does not have a Facebook page. At the same time, he cannot live without his Blackberry and he’s not opposed to texting, he says. By establishing clear guidelines on how to use social media in your practice, such as those recently released by the American Medical Association, practices can help alleviate physician fears about social media and ensure that patient privacy is protected, as well as physicians' personal and professional reputations.

2. Encourage refresher courses and additional training.

Typically, most physicians do not receive refresher training, unless referred to do so by their state’s medical board. But these types of courses can help physicians adopt new practice techniques and return to medicine after a sabbatical.

Not all healthcare fields require mandatory training; in fact, many experienced physicians think refreshers are sometimes a tedious waste of time. But, regardless of age, refresher courses can identify and address the strengths and weaknesses of an individual physician.

Likewise, encouraging all of your physicians to be trained on emerging techniques is critical to keeping your practice current and older docs sharp. For example, Adhir Shroff, MD, cardiologist from the University of Illinois Chicago has noticed an age trend on the slow adoption of transradial catheterization. The catheterization technique used for coronary intervention procedures is performed through the wrist rather than the groin has been shown to cause less bleeding and decreased discomfort for patients. Many younger physicians attend training courses on the procedure, while older physicians have been keeping to the status quo, says Shroff.

" 'If it ain't broke, don't fix it' I hear it over and over. If it makes sense you should just do it," Shroff says, adding that older physicians may miss out and wait until the data is so overwhelming that they are forced to switch methods.

"I've been doing transradial for 16 years and I've seen the ebb and flow of it," says David Mathias, MD, an interventional cardiologist at Aurora BayCare Medical Center in Green Bay, WI.. "We've been asking why it hasn't been catching on and I think the number one reason is inertia, there's no real urgency to learn a different way of doing things," he says.

3. Make mentoring a priority.

To create a beneficial collaboration within a practice Mathias suggests having older and younger physicians paired up as mentors. For instance, younger docs can help older physicians learn to use social media and technology like EHR, and older physicians can share their wisdom from years of experience.

 "Older physicians have the advantage of experience and the good thing about getting old is that you know what to be afraid of. I think younger physicians want to learn new things and get involved on the cutting edge, and you need that to push the status quo," Mathias says. "When you get the two together, you get a nice mixture."

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