Doctors Have Changed, Medical Practice Hasn't

Greatest Generation, Boomers, Gen X, Millennials... as the generations separate from one another their distinctions become more and more important to shaping the practice of medicine. Unfortunately, the education, training and practice of medicine have proven tone-deaf and unable to keep up. That's why so many physicians are seeking to leave practice today.   
There was a time when physicians sought to emulate their predecessors, if not in actual practice and procedures, certainly in style and performance. I've been in this business for nearly forty years, and I've seen physicians continually change and evolve to fit their times. Unfortunately, the practice and/or delivery models of medicine have failed to appreciate those changes and failed miserably to keep up. 

One constant in my healthcare career has been my very close physician interaction and relationships. Whether helping physicians secure new equipment in the hospital, introduce new procedures, recruit new specialties for emerging areas of care, building dedicated medical staffs to meet increasing healthcare competition or as I've done for the past 15-plus years, help physicians find and create rewarding and happy new career paths outside clinical practice, so much of my focus has been on helping doctors be successful.

What has changed most, is the meaning of success. In my early years, when a new physician joined the staff, his/her first questions were always the same, "Can I get extra ER call?" Then, I remember as the question changed, too, "Do I have to take ER call," and then to, "Is call coverage built into the practice," and then to, "What are my hours?" Physicians used to define success by how much they could work and produce and build their practices. Today, practices are mostly owned by an entity other than the physician, and success is predicated on managing burnout and securing free time.  

And, that is where the practice of medicine has failed to keep up with physicians. Burnout represents that conflict. Physician are burned out because medical practice is still predicated on production - separate production from productivity. It is PRODUCTION. If it were productivity, then physicians would not be telling me daily about taking charting home to complete. It is Production - capital "P" intended. Further, this production dependent practice model is wedded to both the reimbursement models in place today and to the entire economic paradigm indicative of a profession that creates new members owing hundreds of thousands of dollars in educational debt. 

For most physicians, that is those with debt, the only career choice has been medical practice (you've heard the phrase "golden handcuffs") since only medical practice starts physicians on day-one earning as much as those in practice for several decades. So, what's the option? Today, and this may surprise you, most nonclinical careers fields have surpassed medicine economically, or at least have come into parity with it. Hospital administrators, for example, used to make about the same income as primary care physicians. Today, their salaries start in the upper six figures and are more often in the low seven figures... You got that right SEVEN FIGURES. 

Therefore the allure of nonclinical jobs is increasing whereas medical practice has failed miserably in keeping pace with physician needs, interests and expectations. Medical practice approaches physician careers in a monolithic fashion.... all doctors are alike. The rest of the world... the nonclinical world, that is, will treat you how you want to be treated. After all, you've changed.  

Add a comment

Email again: