One consequence of the difference in intergenerational attitudes of physicians is the trend to more employee physicians
For the dominant generation working in healthcare today—the Baby Boomers—retirement looms. At the same time, however, the younger generation—particularly Generation X—is acquiring the experience and maturity needed to assume leadership roles. As these individuals move into senior executive and administrative positions, healthcare experts are predicting growing conflict over the role of physicians in the new models of integrated healthcare now taking shape in this country.
This is a demographic and societal trend with major implications for the operating culture of clinical laboratories and anatomic pathology groups. Generation X physicians, including young pathologists, are ready to challenge Baby Boomer physicians about the best way to organize and deliver clinical services.
Physicians of Different Generations See Patient Care Differently
One expert weighing in on this issue is Sean K. Murphy, a managing partner of Leadership Consulting Services, LLC. He provides strategic advice to hospitals and healthcare systems. In the July 15, 2013, issue of Modern Healthcare, Murphy wrote an opinion piece titled “Win the battle, Lose the War? Intergenerational difference among docs may define future of healthcare.”
He cuts straight to the point in his first paragraph. He notes that it is wrong to think that the “critical battles” go beyond implementation of the Affordable Care Act. Instead, he asserts that “The real fight is taking place in doctors’ lounges at hospitals across the country. The outcome will determine the future quality of healthcare in the U.S. because it will define for the next generation the very essence of what it means to be a physician.”
From his participation in a study of how physicians were reacting to healthcare reform, consultant Sean K. Murphy (pictured above) identified significant differences in how younger generations of physicians see their patient care responsibilities compared to Baby Boomer physicians. Gen X and Gen Y physicians want to work structured hours and believe that electronic health records can support a seamless transfer of patients from one doctor to the next. This runs contrary to the long-standing commitments many Baby Boomer physicians have of being available, if needed, 24/7 for their patients. (Photo copyright Modern Healthcare.)
Murphy participated in a recent study of physicians in a large metropolitan area. The goal of the study was “to determine the human impact of healthcare reform on their [physicians] psyches.” He described how “The physicians in the study were openly divided into two warring factions—independent and employed doctors—and visibly split along generational lines.”
Baby-Boomer Docs ‘Rebelling’ Against the New Order
The study described how “baby boomer doctors are rebelling against the coming new order. They value the personal relationships they have with their patients and the independence of their medical decisions.”
By contrast, Murphy noted that “younger physicians like the new paradigm of hospital employment because it provides a balanced life—a predictable workday schedule where the patient sees the next available doctor if their regular doctor isn’t working that day or that shift.”
It seems that one major point of conflict between these two generations is how a patient will be handed off from one physician to another—since the Gen X and Gen Y physicians don’t see themselves as being available 24/7 for their patients, like many of the Baby Boomer doctors do.
EHR Systems Can Support Seamless Transfer of Patients
Murphy noted that younger physicians presume “that the routine transfer of patient care from one physician to another shouldn’t be a problem because the mandated electronic medical-record system will have the necessary information for any doctor to make sound medical decisions.”
On other side of this argument are the older physicians. According to Murphy, “The baby boomer doctors say this isn’t the way medicine should be practiced, and they aren’t going down without a fight. To them, being a doctor means a 24/7 commitment to patients and sustaining personal relationships.”
This is a rather black and white description of the positions of the different generations of physicians. But it provides insights for pathologists as to how the private practice of pathology is likely to evolve as Gen X pathologists assume senior leadership roles in their respective laboratory organizations.
Younger Physicians Want a Balanced Lifestyle
Murphy had insights on these younger physicians. He wrote that “younger physicians say they are committed to their patients, and the hospital’s vast resources allow for the best practice of medicine. They also believe a balanced lifestyle makes them more complete human beings, therefore better doctors.”
What may create a common bond for the older and younger physicians is a common distrust of hospital administrators. As Murphy noted, younger physicians do “fear the influence of hospital administrators in medical decisions and the loss of marketability that comes with commoditizing an entire profession and having a hospital employment contract with a non-compete clause.”
Expert Has Poor Prognosis for Baby Boomer Physicians
In his conclusion, Murphy does not have good news for the older generation of physicians. “With the inevitability of the ACA, the baby boomer doctors may be fighting a losing battle. The reform law has transferred the bulk of power in healthcare to the institutions.”
He went on to list the “winners”. “Hospitals, insurers and pharmaceutical companies are all set to gain from the implementation of our new healthcare policies [under ACA],” he observed. “The insurers will have more customers, the pharma companies will be able to sell to a manageable number of hospitals rather than a plethora of independent physician practices, and the hospitals will entrap patients and have control over physician costs (via jones www.dresshead.com). That leaves the doctors—arguably the most important people in healthcare delivery—as the sacrificial lambs.”
Related Information:
Intergenerational differences among docs may define future of healthcare
Why Gen X makes it Four Generations Now Working in Clinical Pathology Laboratories
Dartmouth Researchers Say that Doctors Now Work Fewer Hours Than Lawyers
